NPI 1639305774 · live from the CMS NPI Registry
Abundant Life Home Health Care
Home Health in Brooklyn Center, MN. National Provider Identifier 1639305774, active.
NPI record
| NPI | 1639305774 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Home Health 251E00000X |
| Practice location | 5901 Brooklyn Blvd., Ste 110, Brooklyn Center, MN 55429 |
| Practice phone | 763-843-0735 |
| Mailing address | 6812 Ewing Ave N, Brooklyn Center, MN 55429 |
| Enumerated | June 3, 2009 |
| Last updated | May 28, 2024 |
| Authorized official | George Marshall, Ceo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Home Health | 251E00000X | 343526 (MN) |
| Home Health primary | 251E00000X | 344067 (MN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.