Provider Demographics
NPI:1902244718
Name:ABUNDANT LIVING HOME HEALTH
Entity Type:Organization
Organization Name:ABUNDANT LIVING HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLANUEVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-564-0168
Mailing Address - Street 1:1115 MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-5509
Mailing Address - Country:US
Mailing Address - Phone:915-564-0168
Mailing Address - Fax:
Practice Address - Street 1:1115 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5509
Practice Address - Country:US
Practice Address - Phone:915-564-0168
Practice Address - Fax:210-714-0168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-13
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health