Provider Demographics
NPI:1225705205
Name:ABUNDANT HOME CARE SERVICES INC
Entity Type:Organization
Organization Name:ABUNDANT HOME CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARDEA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-605-8716
Mailing Address - Street 1:10926 DAVID TAYLOR DR STE 120-098
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-1293
Mailing Address - Country:US
Mailing Address - Phone:704-605-8716
Mailing Address - Fax:
Practice Address - Street 1:10926 DAVID TAYLOR DR STE 120-098
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-1293
Practice Address - Country:US
Practice Address - Phone:704-605-8716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care