Organization
ABUNDANT LIFE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOPHIA FISHER (OWNER)
(816) 668-5586
Entity
Organization
Contact information
Practice address
16823 NE 116TH ST, LIBERTY, MO 64068-8278
(816) 668-5586
(816) 453-9068
Mailing address
16823 NE 116TH ST, LIBERTY, MO 64068-8278
(816) 668-5586
(816) 453-9068
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/04/2016
Last updated
12/04/2016
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