Provider Demographics
NPI:1710404785
Name:A BETTER LIFE 2 EMBRACE LLC (A.B.L.E.) LLC
Entity Type:Organization
Organization Name:A BETTER LIFE 2 EMBRACE LLC (A.B.L.E.) LLC
Other - Org Name:A.B.L.E. LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KENDALL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:SR
Authorized Official - Credentials:CDCA,QMHS
Authorized Official - Phone:567-395-5711
Mailing Address - Street 1:3450 W CENTRAL AVE STE 366E
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1416
Mailing Address - Country:US
Mailing Address - Phone:567-395-5711
Mailing Address - Fax:
Practice Address - Street 1:3450 W CENTRAL AVE STE 366E
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1416
Practice Address - Country:US
Practice Address - Phone:567-395-5711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-29
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1720501463Medicaid