Provider Demographics
NPI:1447418355
Name:ABLE CARE PROVIDERS LLC
Entity Type:Organization
Organization Name:ABLE CARE PROVIDERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VARICK
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:RODNEY
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:225-272-3941
Mailing Address - Street 1:3738 REDLANDS DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70814-5247
Mailing Address - Country:US
Mailing Address - Phone:225-272-3941
Mailing Address - Fax:
Practice Address - Street 1:3738 REDLANDS DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70814-5247
Practice Address - Country:US
Practice Address - Phone:225-272-3941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12643251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1787396Medicaid