Provider Demographics
NPI:1093151359
Name:ABLE SUPPORT FACILITATORS
Entity Type:Organization
Organization Name:ABLE SUPPORT FACILITATORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:ONARI
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-989-3524
Mailing Address - Street 1:5 STRATFORD DR APT 113
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-2145
Mailing Address - Country:US
Mailing Address - Phone:434-989-3524
Mailing Address - Fax:
Practice Address - Street 1:5 STRATFORD DR APT 113
Practice Address - Street 2:
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2145
Practice Address - Country:US
Practice Address - Phone:434-989-3524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility