Provider Demographics
NPI:1376273235
Name:ABLELIGHT INC.
Entity Type:Organization
Organization Name:ABLELIGHT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF TREASURY
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MINNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-206-4459
Mailing Address - Street 1:600 HOFFMANN DR
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53094-6223
Mailing Address - Country:US
Mailing Address - Phone:920-261-3050
Mailing Address - Fax:
Practice Address - Street 1:3500 S LINCOLN ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3632
Practice Address - Country:US
Practice Address - Phone:303-357-1388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health