Provider Demographics
NPI:1023570710
Name:ABUNDANT LIFE SOLUTION
Entity Type:Organization
Organization Name:ABUNDANT LIFE SOLUTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VAHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAKOBYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-888-0088
Mailing Address - Street 1:4339 MCROBERTS DR
Mailing Address - Street 2:
Mailing Address - City:MATHER
Mailing Address - State:CA
Mailing Address - Zip Code:95655-3026
Mailing Address - Country:US
Mailing Address - Phone:916-888-0088
Mailing Address - Fax:
Practice Address - Street 1:4339 MCROBERTS DR
Practice Address - Street 2:
Practice Address - City:MATHER
Practice Address - State:CA
Practice Address - Zip Code:95655-3026
Practice Address - Country:US
Practice Address - Phone:916-888-0088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)