Provider Demographics
NPI:1184948572
Name:KIDS ABILITIES, INC.
Entity type:Organization
Organization Name:KIDS ABILITIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:E
Authorized Official - Last Name:GILLIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:651-451-3016
Mailing Address - Street 1:4638 VICTOR PATH
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HUGO
Mailing Address - State:MN
Mailing Address - Zip Code:55038
Mailing Address - Country:US
Mailing Address - Phone:651-407-3777
Mailing Address - Fax:651-407-7064
Practice Address - Street 1:4638 VICTOR PATH
Practice Address - Street 2:SUITE 100
Practice Address - City:HUGO
Practice Address - State:MN
Practice Address - Zip Code:55038
Practice Address - Country:US
Practice Address - Phone:651-407-3777
Practice Address - Fax:651-407-7064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN275420700Medicaid