Provider Demographics
NPI:1801269238
Name:ABUNDANT LIVING INC
Entity type:Organization
Organization Name:ABUNDANT LIVING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-341-3910
Mailing Address - Street 1:618 OAKLEAF OFFICE LN
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-4825
Mailing Address - Country:US
Mailing Address - Phone:901-207-6357
Mailing Address - Fax:
Practice Address - Street 1:618 OAKLEAF OFFICE LN
Practice Address - Street 2:SUITE 200
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-4825
Practice Address - Country:US
Practice Address - Phone:901-207-6357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-06
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNI000000015438253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care