Provider Demographics
NPI:1073059846
Name:UNIQUE ABILITIES, LLC
Entity Type:Organization
Organization Name:UNIQUE ABILITIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PROGRAM SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANNA
Authorized Official - Last Name:SIMONETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-756-1804
Mailing Address - Street 1:259 MAIN ST E
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:56096-1467
Mailing Address - Country:US
Mailing Address - Phone:507-362-4321
Mailing Address - Fax:
Practice Address - Street 1:259 MAIN ST E
Practice Address - Street 2:UNIQUE ABILITIES, LLC
Practice Address - City:WATERVILLE
Practice Address - State:MN
Practice Address - Zip Code:56096-1467
Practice Address - Country:US
Practice Address - Phone:507-362-4321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1084134-2-HCBS253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care