Organization
ABUNDANT LIFE HCS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MACK G. JONES (PROGRAM MANAGER)
(903) 537-7404
Entity
Organization
Contact information
Practice address
102 HOUSTON ST N, MOUNT VERNON, TX 75457-2409
(903) 537-7404
(903) 537-4406
Mailing address
PO BOX 461, MOUNT VERNON, TX 75457-0461
(903) 537-7404
(903) 537-4406
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/11/2006
Last updated
08/22/2020
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