Provider Demographics
NPI:1114582921
Name:STABLE POSSIBILITIES LLC
Entity Type:Organization
Organization Name:STABLE POSSIBILITIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-946-0126
Mailing Address - Street 1:7081 FINNEGAN RD
Mailing Address - Street 2:
Mailing Address - City:JOHANNESBURG
Mailing Address - State:MI
Mailing Address - Zip Code:49751-9705
Mailing Address - Country:US
Mailing Address - Phone:586-946-0126
Mailing Address - Fax:
Practice Address - Street 1:27751 24 MILE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48051-1602
Practice Address - Country:US
Practice Address - Phone:586-292-8472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-07
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty