Provider Demographics
NPI:1770921926
Name:ABUNDANT CONSUMER DIRECT SERVICES
Entity type:Organization
Organization Name:ABUNDANT CONSUMER DIRECT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:VANTRICE
Authorized Official - Last Name:GREER
Authorized Official - Suffix:
Authorized Official - Credentials:TRADE ASSCIATE DEGRE
Authorized Official - Phone:314-727-8700
Mailing Address - Street 1:230 S BEMISTON AVE
Mailing Address - Street 2:SUITE 540
Mailing Address - City:CLAYTON
Mailing Address - State:MO
Mailing Address - Zip Code:63105-1907
Mailing Address - Country:US
Mailing Address - Phone:331-472-7870
Mailing Address - Fax:866-255-9006
Practice Address - Street 1:230 S BEMISTON AVE
Practice Address - Street 2:SUITE 540
Practice Address - City:CLAYTON
Practice Address - State:MO
Practice Address - Zip Code:63105-1907
Practice Address - Country:US
Practice Address - Phone:331-472-7870
Practice Address - Fax:866-255-9006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health