Provider Demographics
NPI:1356925655
Name:ABUNDANCE OF LOVE
Entity type:Organization
Organization Name:ABUNDANCE OF LOVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:513-578-2706
Mailing Address - Street 1:9090 HANOVER ST
Mailing Address - Street 2:
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-6412
Mailing Address - Country:US
Mailing Address - Phone:404-509-1462
Mailing Address - Fax:
Practice Address - Street 1:3383 GRAYSTONE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-5719
Practice Address - Country:US
Practice Address - Phone:404-509-1462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRUILASH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health