Organization
ABUNDANT LIFE NURSING AND SUPPORTIVE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA FRAN ALLEN (PRESIDENT)
(352) 459-1245
Entity
Organization
Contact information
Practice address
1617 E ALFRED ST, TAVARES, FL 32778-3535
(352) 459-1245
Mailing address
1617 E ALFRED ST, TAVARES, FL 32778-3535
(352) 459-1245
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
RN9281220
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008118000
—
FL
Enumeration date
06/08/2015
Last updated
06/08/2015
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