Provider Demographics
NPI:1487846309
Name:ABUNDANCE CARE LLC
Entity Type:Organization
Organization Name:ABUNDANCE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-484-0934
Mailing Address - Street 1:4273 E SPEARFISH DR
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-6349
Mailing Address - Country:US
Mailing Address - Phone:208-854-7036
Mailing Address - Fax:208-854-7126
Practice Address - Street 1:22965 CONRAD CT
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:ID
Practice Address - Zip Code:83644-5365
Practice Address - Country:US
Practice Address - Phone:208-484-0934
Practice Address - Fax:208-854-7126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based