Provider Demographics
NPI:1306475637
Name:ABUNDANT HEART HOME CARE LLC
Entity type:Organization
Organization Name:ABUNDANT HEART HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:NUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-819-1888
Mailing Address - Street 1:PO BOX 841501
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-0138
Mailing Address - Country:US
Mailing Address - Phone:281-819-1888
Mailing Address - Fax:
Practice Address - Street 1:3418 WHITMAN DR
Practice Address - Street 2:
Practice Address - City:IOWA COLONY
Practice Address - State:TX
Practice Address - Zip Code:77583-1210
Practice Address - Country:US
Practice Address - Phone:281-819-1888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-07
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care