Provider Demographics
NPI:1851073407
Name:ABUNDANT LOVE AND CARE HCS, INC
Entity Type:Organization
Organization Name:ABUNDANT LOVE AND CARE HCS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-716-6737
Mailing Address - Street 1:2951 PICCADILLY LN APT 616
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76207-2093
Mailing Address - Country:US
Mailing Address - Phone:817-716-6737
Mailing Address - Fax:
Practice Address - Street 1:2951 PICCADILLY LN APT 616
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76207-2093
Practice Address - Country:US
Practice Address - Phone:817-716-6737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-03
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities