Provider Demographics
NPI:1518508720
Name:ABILITY HEALTH SYSTEMS, LLC
Entity Type:Organization
Organization Name:ABILITY HEALTH SYSTEMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JACQUENLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:AMERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:832-960-1650
Mailing Address - Street 1:4526 GREEN FAWN LN
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-9584
Mailing Address - Country:US
Mailing Address - Phone:832-960-1650
Mailing Address - Fax:
Practice Address - Street 1:4526 GREEN FAWN LN
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-9584
Practice Address - Country:US
Practice Address - Phone:832-960-1650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-30
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX394-4043Medicaid