Provider Demographics
NPI:1114504677
Name:SUSTAINED ABILITY, LLC
Entity Type:Organization
Organization Name:SUSTAINED ABILITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLOUD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:512-820-6019
Mailing Address - Street 1:1209 W SAINT JOHNS AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-1935
Mailing Address - Country:US
Mailing Address - Phone:512-820-6019
Mailing Address - Fax:
Practice Address - Street 1:1209 W SAINT JOHNS AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-1935
Practice Address - Country:US
Practice Address - Phone:512-820-6019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy