Provider Demographics
NPI:1255832333
Name:ABLE HEALTH GROUP, LLC
Entity Type:Organization
Organization Name:ABLE HEALTH GROUP, LLC
Other - Org Name:ABLE HOSPICE, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:MWANSA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:714-943-6454
Mailing Address - Street 1:41990 COOK ST, BLD F, STE 2004
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-6105
Mailing Address - Country:US
Mailing Address - Phone:760-610-2093
Mailing Address - Fax:760-610-2115
Practice Address - Street 1:41990 COOK ST, BLD F, STE 2004
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-6105
Practice Address - Country:US
Practice Address - Phone:760-610-2093
Practice Address - Fax:760-610-2115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-23
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based