| Abundant Grace Llc | |
|
7227 S Central Ave #1080 Phoenix AZ 85042-2951 | |
| (623) 521-5935 | |
| (602) 441-4838 |
| Full Name | Abundant Grace Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 7227 S Central Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Olufemi Omodara (OWNER) |
| Authorized Official Contact | 6235215935 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Abundant Grace Llc P.o. Box 5693 Goodyear AZ 85338 Ph: (623) 521-5935 | Abundant Grace Llc 7227 S Central Ave #1080 Phoenix AZ 85042-2951 Ph: (623) 521-5935 |
| NPI Number | 1316644636 |
|---|---|
| Provider Enumeration Date | 02/08/2023 |
| Last Update Date | 02/08/2023 |
| Certification Date | 02/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316644636 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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