| Abundant Life Centers Llc | |
|
2475 Palm Bay Rd Ne Ste 145-23 Palm Bay FL 32905-3317 | |
| (321) 345-6831 | |
| Not Available |
| Full Name | Abundant Life Centers Llc |
|---|---|
| Speciality | Counselor |
| Location | 2475 Palm Bay Rd Ne Ste 145-23, Palm Bay, Florida |
| Authorized Official Name and Position | Charlene Morris (SOLE MEMBER) |
| Authorized Official Contact | 3213456831 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Abundant Life Centers Llc Po Box 121196 Melbourne FL 32912-1196 Ph: (321) 345-6831 | Abundant Life Centers Llc 2475 Palm Bay Rd Ne Ste 145-23 Palm Bay FL 32905-3317 Ph: (321) 345-6831 |
| NPI Number | 1003481706 |
|---|---|
| Provider Enumeration Date | 05/25/2021 |
| Last Update Date | 05/25/2021 |
| Certification Date | 05/25/2021 |
| Medicare PECOS PAC ID | 5991158123 |
|---|---|
| Medicare Enrollment ID | O20240124002175 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003481706 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Charlene W Morris |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982184610 PECOS PAC ID: 6800249038 Enrollment ID: I20240124002897 |
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