Provider Demographics
NPI:1982472965
Name:ABUNDANT LIFE OCCUPATIONAL THERAPY LLC
Entity Type:Organization
Organization Name:ABUNDANT LIFE OCCUPATIONAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:412-523-8258
Mailing Address - Street 1:9484 STONE VIEW DR NE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-7471
Mailing Address - Country:US
Mailing Address - Phone:412-523-8258
Mailing Address - Fax:
Practice Address - Street 1:9484 STONE VIEW DR NE
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:MI
Practice Address - Zip Code:49341-7471
Practice Address - Country:US
Practice Address - Phone:412-523-8258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center