Provider Demographics
NPI:1104401017
Name:TEAM ABILITIES LLC
Entity Type:Organization
Organization Name:TEAM ABILITIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:JELKS
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:713-865-0254
Mailing Address - Street 1:1029 PRUITT RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3024
Mailing Address - Country:US
Mailing Address - Phone:832-501-0282
Mailing Address - Fax:866-434-1073
Practice Address - Street 1:1029 PRUITT RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-3024
Practice Address - Country:US
Practice Address - Phone:832-501-0282
Practice Address - Fax:866-434-1073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001008854Medicaid