Organization
ABUNDANCE OF LIFE ADULT FAMILY HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAHAD IBRAHIM PHD (ADMINISTRATOR IN TRAINING)
(651) 251-7100
Entity
Organization
Contact information
Practice address
2355 HIGHWAY 36 W STE 431, ROSEVILLE, MN 55113-3902
(651) 251-7100
Mailing address
2355 HIGHWAY 36 W STE 431, ROSEVILLE, MN 55113-3902
(651) 251-7100
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
01/17/2020
Last updated
01/17/2020
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