Provider Demographics
NPI:1902038417
Name:MORE ABUNDANT LIVING INSTITUTE, P.C.
Entity Type:Organization
Organization Name:MORE ABUNDANT LIVING INSTITUTE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:708-799-5862
Mailing Address - Street 1:19516 NORTHWINDS DR
Mailing Address - Street 2:
Mailing Address - City:LYNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60411-8660
Mailing Address - Country:US
Mailing Address - Phone:708-799-5862
Mailing Address - Fax:708-799-0138
Practice Address - Street 1:19516 NORTHWINDS DR
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60411-8660
Practice Address - Country:US
Practice Address - Phone:708-799-5862
Practice Address - Fax:708-799-0138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-17
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty