Organization
ABUNDANT LIFE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TROY MOSES PRESINDENT (CEO)
(860) 548-9399
Entity
Organization
Contact information
Practice address
2550 MAIN ST, HARTFORD, CT 06120-1936
(860) 548-9399
Mailing address
PO BOX 714, HARTFORD, CT 06142-0714
(860) 548-9399
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
104100000X
CT
251B00000X
Case Management Agency
001806
CT
251S00000X
Community/Behavioral Health Agency
001806
CT
Other
Enumeration date
06/08/2009
Last updated
04/16/2013
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