Organization
ABUNDANT LIFE RESIDENTIAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATONYA PATRICE POWELL (DIRECTOR)
(202) 498-4557
Entity
Organization
Contact information
Practice address
8000 PRINCE GEORGES DR, FORT WASHINGTON, MD 20744-2264
(202) 498-4557
Mailing address
8000 PRINCE GEORGES DR, FORT WASHINGTON, MD 20744-2264
(202) 498-4557
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035966800
—
DC
Enumeration date
06/15/2011
Last updated
06/15/2011
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