Organization
ABUNDANT LIVING LIMITED LIABILITY COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASYA BUSSIE (OWNER)
(443) 629-0696
Entity
Organization
Contact information
Practice address
8821 WINTERBROOK RD, RANDALLSTOWN, MD 21133-4174
(443) 629-0696
Mailing address
8821 WINTERBROOK RD, RANDALLSTOWN, MD 21133-4174
(443) 629-0696
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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