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Organization

BOUNTIFUL LIVING AND ASSISTANCE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHANIKA NICKELBERRY (OWNER)
(501) 353-8336
Entity
Organization

Contact information

Practice address
5713 DREXEL AVE, LITTLE ROCK, AR 72209-8413
(501) 396-9916
Mailing address
6834 CANTRELL RD STE 1648, LITTLE ROCK, AR 72207-4135
(501) 353-8336

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
103K00000X
Behavior Analyst
106E00000X
Assistant Behavior Analyst
106S00000X
Behavior Technician
171M00000X
Case Manager/Care Coordinator
Primary
172V00000X
Community Health Worker
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency

Other

Enumeration date
03/06/2026
Last updated
03/06/2026
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