Provider Demographics
NPI:1558084558
Name:ABLE ABILITIES, LCC
Entity Type:Organization
Organization Name:ABLE ABILITIES, LCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:FOXWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-679-8715
Mailing Address - Street 1:2320 E BASELINE RD STE 148-485
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-6966
Mailing Address - Country:US
Mailing Address - Phone:480-679-8715
Mailing Address - Fax:
Practice Address - Street 1:4852 S 20TH PL
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040-2513
Practice Address - Country:US
Practice Address - Phone:602-283-4144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABLE ABILITIES. LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)