Provider Demographics
NPI:1346455037
Name:ABLE STRIDES LLC
Entity Type:Organization
Organization Name:ABLE STRIDES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER REHAB DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:JILL
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:OTL
Authorized Official - Phone:505-235-7922
Mailing Address - Street 1:5237 RUSSELL DR NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-4326
Mailing Address - Country:US
Mailing Address - Phone:505-235-7922
Mailing Address - Fax:505-635-4112
Practice Address - Street 1:5237 RUSSELL DR NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-4326
Practice Address - Country:US
Practice Address - Phone:505-235-7922
Practice Address - Fax:505-635-4112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1889224Z00000X
NM985225100000X
NM486225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMD4326Medicaid