Provider Demographics
NPI:1043804727
Name:ABUNDANT LIVING SUPPORTS COORDINATION LLC
Entity Type:Organization
Organization Name:ABUNDANT LIVING SUPPORTS COORDINATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:TITUS
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:814-769-0124
Mailing Address - Street 1:1215 SCHIMMER ST STE 1
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-2458
Mailing Address - Country:US
Mailing Address - Phone:814-769-0124
Mailing Address - Fax:
Practice Address - Street 1:1215 SCHIMMER ST STE 1
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-2458
Practice Address - Country:US
Practice Address - Phone:814-769-0124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management