Provider Demographics
NPI:1003687526
Name:ABUNDANT LOVE & CARE ASSISTED LIVING FACILITY 2 INC.
Entity Type:Organization
Organization Name:ABUNDANT LOVE & CARE ASSISTED LIVING FACILITY 2 INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLADIS
Authorized Official - Middle Name:
Authorized Official - Last Name:VACCIANNA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:863-860-5699
Mailing Address - Street 1:825 PLUM ST
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33801-1970
Mailing Address - Country:US
Mailing Address - Phone:863-307-2421
Mailing Address - Fax:863-307-2521
Practice Address - Street 1:825 PLUM ST
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-1970
Practice Address - Country:US
Practice Address - Phone:863-307-2421
Practice Address - Fax:863-307-2521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility