1821619453 NPI number — ABILITIES UNLIMITED LLC

Table of content: (NPI 1821619453)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821619453 NPI number — ABILITIES UNLIMITED LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABILITIES UNLIMITED LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821619453
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/05/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1919 OXMOOR RD # 272
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35209-3502
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-678-2767
Provider Business Mailing Address Fax Number:
888-678-2767

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1761 WIRE RD APT 4-7
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36832-6645
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-678-2767
Provider Business Practice Location Address Fax Number:
888-678-2767
Provider Enumeration Date:
05/05/2020

Additional Information

Authorized Official

Authorized Official Last Name:
PEEBLES
Authorized Official First Name:
ERIC
Authorized Official Middle Name:
MINTON
Authorized Official Title or Position:
PRESIDENT AND CEO
Authorized Official Telephone Number:
888-678-2767

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 14660722 . This is a "NCQH" identifier . This identifiers is of the category "OTHER".




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