| Abundant Life Services, Llc | |
|
1701 W Allen St Rice Lake WI 54868-1872 | |
| (715) 642-1961 | |
| Not Available |
| Full Name | Abundant Life Services, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1701 W Allen St, Rice Lake, Wisconsin |
| Authorized Official Name and Position | Donna L Glaser (PRESIDENT) |
| Authorized Official Contact | 7156421961 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Abundant Life Services, Llc 1311 S Main St # 183 Rice Lake WI 54868-2828 Ph: (715) 642-1961 | Abundant Life Services, Llc 1701 W Allen St Rice Lake WI 54868-1872 Ph: (715) 642-1961 |
| NPI Number | 1255978953 |
|---|---|
| Provider Enumeration Date | 12/02/2019 |
| Last Update Date | 12/19/2019 |
| Certification Date | 12/19/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255978953 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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