Organization
ABUNDANT LIFE HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ADEMOLA WALE OLOYEDE-ASANIKE (DIRECTOR OF FINANCE)
(502) 418-6447
Entity
Organization
Contact information
Practice address
331 E MAIN ST STE 216, ROCK HILL, SC 29730-5384
(803) 448-2765
Mailing address
331 E MAIN ST STE 216, ROCK HILL, SC 29730-5384
(803) 448-2765
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
IHCP-0842
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IHCP-0842
PRIVATE
SC
05
—
IHCP-0842
—
SC
Enumeration date
06/01/2018
Last updated
06/01/2018
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