Provider Demographics
NPI:1710495809
Name:ABILITY, LLC - III
Entity Type:Organization
Organization Name:ABILITY, LLC - III
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:601-441-9821
Mailing Address - Street 1:285 HOLMES PITTMAN RD
Mailing Address - Street 2:
Mailing Address - City:FOXWORTH
Mailing Address - State:MS
Mailing Address - Zip Code:39483-3166
Mailing Address - Country:US
Mailing Address - Phone:601-441-9821
Mailing Address - Fax:
Practice Address - Street 1:6092 PLAZA DR
Practice Address - Street 2:
Practice Address - City:TYLERTOWN
Practice Address - State:MS
Practice Address - Zip Code:39667-9211
Practice Address - Country:US
Practice Address - Phone:601-441-6161
Practice Address - Fax:601-444-5036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-11
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS3330235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS08025091Medicaid