Provider Demographics
NPI:1114169034
Name:LIFE ABLED LLC
Entity Type:Organization
Organization Name:LIFE ABLED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENR/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-444-6333
Mailing Address - Street 1:125 HALF MILE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-6749
Mailing Address - Country:US
Mailing Address - Phone:732-444-6333
Mailing Address - Fax:480-393-5688
Practice Address - Street 1:125 HALF MILE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-6749
Practice Address - Country:US
Practice Address - Phone:732-444-6333
Practice Address - Fax:480-393-5688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-25
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ253E0000X- IN HOME S253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care