Provider Demographics
NPI:1245029297
Name:ABUNDANCE HEALTH AND WELLNESS LLC
Entity type:Organization
Organization Name:ABUNDANCE HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EBISA
Authorized Official - Middle Name:
Authorized Official - Last Name:WORIKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-222-1979
Mailing Address - Street 1:4740 42ND AVE N STE 202
Mailing Address - Street 2:
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-1828
Mailing Address - Country:US
Mailing Address - Phone:612-222-1979
Mailing Address - Fax:
Practice Address - Street 1:4740 42ND AVE N STE 202
Practice Address - Street 2:
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-1828
Practice Address - Country:US
Practice Address - Phone:612-222-1979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-06
Last Update Date:2025-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health