Provider Demographics
NPI:1184452443
Name:ABUNDANCE OF CARE HOSPICE LLC
Entity type:Organization
Organization Name:ABUNDANCE OF CARE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MORENO
Authorized Official - Middle Name:WEBSTER
Authorized Official - Last Name:DELA ROSA
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:702-356-9052
Mailing Address - Street 1:3305 SPRING MOUNTAIN RD STE 86
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-8630
Mailing Address - Country:US
Mailing Address - Phone:702-356-9052
Mailing Address - Fax:702-356-8950
Practice Address - Street 1:3305 SPRING MOUNTAIN RD STE 86
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-8630
Practice Address - Country:US
Practice Address - Phone:702-356-9052
Practice Address - Fax:702-356-8950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based