Provider Demographics
NPI:1306729884
Name:ABUNDANT ROCK, LLC
Entity type:Organization
Organization Name:ABUNDANT ROCK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/INSTRUCTOR
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:JULIA
Authorized Official - Last Name:LASER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA, RYT
Authorized Official - Phone:312-505-8787
Mailing Address - Street 1:62 WALDRON ST
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242-1818
Mailing Address - Country:US
Mailing Address - Phone:312-505-8787
Mailing Address - Fax:
Practice Address - Street 1:62 WALDRON ST
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-1818
Practice Address - Country:US
Practice Address - Phone:312-505-8787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center