Provider Demographics
NPI:1669569802
Name:ABUNDANT HOME CARE, INC
Entity type:Organization
Organization Name:ABUNDANT HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:ESLICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-748-2288
Mailing Address - Street 1:12545 KIRKHAM CT
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-6815
Mailing Address - Country:US
Mailing Address - Phone:858-748-2288
Mailing Address - Fax:858-748-5688
Practice Address - Street 1:12545 KIRKHAM CT
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-6815
Practice Address - Country:US
Practice Address - Phone:858-748-2288
Practice Address - Fax:858-748-5688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45980332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1323980001Medicare ID - Type Unspecified