Provider Demographics
NPI:1275680928
Name:ABILITIES UNLIMITED, LLC
Entity Type:Organization
Organization Name:ABILITIES UNLIMITED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:GAYLE
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-433-7271
Mailing Address - Street 1:309 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-1870
Mailing Address - Country:US
Mailing Address - Phone:859-433-7271
Mailing Address - Fax:502-226-3112
Practice Address - Street 1:309 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-1870
Practice Address - Country:US
Practice Address - Phone:859-433-7271
Practice Address - Fax:502-226-3112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY33000837177F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes177F00000XOther Service ProvidersLodgingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY33000837OtherMEDICAID PROVIDER NUMBER