Provider Demographics
NPI: | 1821619453 |
---|---|
Name: | ABILITIES UNLIMITED LLC |
Entity Type: | Organization |
Organization Name: | ABILITIES UNLIMITED LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT AND CEO |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | ERIC |
Authorized Official - Middle Name: | MINTON |
Authorized Official - Last Name: | PEEBLES |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PHD, CRC, LPC |
Authorized Official - Phone: | 888-678-2767 |
Mailing Address - Street 1: | 1919 OXMOOR RD # 272 |
Mailing Address - Street 2: | |
Mailing Address - City: | BIRMINGHAM |
Mailing Address - State: | AL |
Mailing Address - Zip Code: | 35209-3502 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 888-678-2767 |
Mailing Address - Fax: | 888-678-2767 |
Practice Address - Street 1: | 1761 WIRE RD APT 4-7 |
Practice Address - Street 2: | |
Practice Address - City: | AUBURN |
Practice Address - State: | AL |
Practice Address - Zip Code: | 36832-6645 |
Practice Address - Country: | US |
Practice Address - Phone: | 888-678-2767 |
Practice Address - Fax: | 888-678-2767 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-05-05 |
Last Update Date: | 2020-05-05 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251S00000X | Agencies | Community/Behavioral Health |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
14660722 | Other | NCQH |