Provider Demographics
NPI:1770013450
Name:ABUNDANT WORKS ENRICHMENT SERVICES LLC
Entity Type:Organization
Organization Name:ABUNDANT WORKS ENRICHMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:BATTLES-BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-724-7074
Mailing Address - Street 1:215 E WATERLOO RD STE 12
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44319-1236
Mailing Address - Country:US
Mailing Address - Phone:330-724-7074
Mailing Address - Fax:
Practice Address - Street 1:215 E WATERLOO RD STE 12
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44319-1236
Practice Address - Country:US
Practice Address - Phone:330-724-7074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0075071Medicaid