Provider Demographics
NPI:1861234304
Name:ABUNDANT LIFE ADULT DAY HEALTH NONPROFIT CORP
Entity type:Organization
Organization Name:ABUNDANT LIFE ADULT DAY HEALTH NONPROFIT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:HERLANIUS
Authorized Official - Middle Name:M
Authorized Official - Last Name:TATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-654-9137
Mailing Address - Street 1:2401 PRENTISS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-5329
Mailing Address - Country:US
Mailing Address - Phone:504-240-2900
Mailing Address - Fax:504-241-6000
Practice Address - Street 1:2401 PRENTISS AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-5329
Practice Address - Country:US
Practice Address - Phone:504-240-2900
Practice Address - Fax:504-241-6000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174200000XOther Service ProvidersMeals