OrganizationActive
Abundant Living Group Home, Inc
NPI 1164616835 · Emotionally Disturbed Childrens' Residential Treatment Facility · Eden, NC
Provider details
- NPI number
- 1164616835
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Janice Timpson, Owner(336) 623-7669
- License
- MHL-079-076 (NC)
Specialties & taxonomies
- Emotionally Disturbed Childrens' Residential Treatment FacilityPrimary322D00000XLicense MHL-079-076 (NC)
Residential Treatment Facilities
Practice location
438 Creekridge Dr
Eden, NC 27288-2817
Phone: (336) 623-7669
Fax: (336) 623-1139
Approximate (ZIP-level) locationGet directions
Mailing address
438 Creekridge Dr
Eden, NC 27288-2817
Other names (DBA / former)
- Doing business as
- New Abundant Living I
Registry dates
- Enumerated
- 2007-09-05
- Last updated
- 2007-09-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.