Provider Demographics
NPI:1447957840
Name:ABUNDANT BLESSING AND FAMILY SERVICES LLC
Entity type:Organization
Organization Name:ABUNDANT BLESSING AND FAMILY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:SWANN
Authorized Official - Suffix:JR
Authorized Official - Credentials:QMHP-C
Authorized Official - Phone:804-955-6218
Mailing Address - Street 1:18532 TWISTED OAK CT
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23834
Mailing Address - Country:US
Mailing Address - Phone:804-955-6218
Mailing Address - Fax:
Practice Address - Street 1:7641 HALL STREET ROAD
Practice Address - Street 2:SUITE 205
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235
Practice Address - Country:US
Practice Address - Phone:804-728-2772
Practice Address - Fax:804-728-2771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-15
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty