Provider Demographics
NPI:1225623440
Name:ENABLE, INC.
Entity Type:Organization
Organization Name:ENABLE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:E
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-255-2851
Mailing Address - Street 1:1836 RAVEN DR
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-1223
Mailing Address - Country:US
Mailing Address - Phone:701-255-2851
Mailing Address - Fax:701-258-4765
Practice Address - Street 1:1836 RAVEN DR
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-1223
Practice Address - Country:US
Practice Address - Phone:701-255-2851
Practice Address - Fax:701-258-4765
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENABLE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1456404Medicaid
ND1456405Medicaid
ND1456398Medicaid
ND1456401Medicaid
ND1456381Medicaid
ND1456393Medicaid