Provider Demographics
NPI:1710222047
Name:ABILITY WORKS OUTPATIENT SERVICES, LLC
Entity Type:Organization
Organization Name:ABILITY WORKS OUTPATIENT SERVICES, LLC
Other - Org Name:ABILITY PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ELIAS
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-410-0126
Mailing Address - Street 1:18791 15 MILE RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-2503
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18791 15 MILE RD
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48035-2503
Practice Address - Country:US
Practice Address - Phone:586-790-2427
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-27
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
MID83022261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MID83022OtherSTATE ID
MID83022OtherSTATE ID