Provider Demographics
NPI:1346526076
Name:ABUNDANT TREASURES
Entity Type:Organization
Organization Name:ABUNDANT TREASURES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TYNISHA
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:JEFFERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-998-5042
Mailing Address - Street 1:1325 DAJA LN
Mailing Address - Street 2:706
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-7647
Mailing Address - Country:US
Mailing Address - Phone:972-998-5042
Mailing Address - Fax:972-829-8939
Practice Address - Street 1:1325 DAJA LN
Practice Address - Street 2:APT 706
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-7647
Practice Address - Country:US
Practice Address - Phone:972-998-5042
Practice Address - Fax:972-829-8939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health