Provider Demographics
NPI:1134802556
Name:HER ABILITIES, INC.
Entity type:Organization
Organization Name:HER ABILITIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:DAPHNE
Authorized Official - Last Name:GILLOM-MILES
Authorized Official - Suffix:
Authorized Official - Credentials:CLA
Authorized Official - Phone:757-650-8734
Mailing Address - Street 1:333 N PATRICK ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-2442
Mailing Address - Country:US
Mailing Address - Phone:757-650-8734
Mailing Address - Fax:
Practice Address - Street 1:8826 HARDESTY DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4703
Practice Address - Country:US
Practice Address - Phone:757-650-8734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility