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Organization

ABUNDANT LIFE CARE SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CLARENCE CARTER (CEO)
(336) 682-2908
Entity
Organization

Contact information

Practice address
163 STRATFORD CT, SUITE 236, WINSTON SALEM, NC 27103-1836
(336) 682-2908
Mailing address
163 STRATFORD CT, BOX 26, WINSTON SALEM, NC 27103-1836
(336) 682-2908

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
01/05/2009
Last updated
01/05/2009
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