Provider Demographics
NPI:1417010604
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:920-261-8441
Practice Address - Street 1:600 HOFFMANN DR
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:WI
Practice Address - Zip Code:53094-6223
Practice Address - Country:US
Practice Address - Phone:920-261-3050
Practice Address - Fax:920-261-8441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL315P00000X, 320900000X
TX315P00000X, 320900000X
WI320900000X
MI320900000X
OH320900000X
IN320900000X
NJ320900000X
MO320900000X
FL320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities