Provider Demographics
NPI:1649454778
Name:ABLE LIFE CARE SERVICES, INC.
Entity type:Organization
Organization Name:ABLE LIFE CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:CLOFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-367-5511
Mailing Address - Street 1:252 HECTOR AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056
Mailing Address - Country:US
Mailing Address - Phone:504-367-5511
Mailing Address - Fax:504-367-5512
Practice Address - Street 1:401 WHITNEY AVE STE 302
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-2402
Practice Address - Country:US
Practice Address - Phone:504-367-5511
Practice Address - Fax:504-367-5512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9207372600000X, 3747P1801X, 374U00000X, 376J00000X, 3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1557862Medicaid