Provider Demographics
NPI:1700951720
Name:ABLE THERAPY SERVICES
Entity Type:Organization
Organization Name:ABLE THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:KEITH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR
Authorized Official - Phone:805-782-9300
Mailing Address - Street 1:1411 MARSH ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-2957
Mailing Address - Country:US
Mailing Address - Phone:805-782-9300
Mailing Address - Fax:805-782-9700
Practice Address - Street 1:1411 MARSH ST
Practice Address - Street 2:SUITE 107
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-2957
Practice Address - Country:US
Practice Address - Phone:805-782-9300
Practice Address - Fax:805-782-9700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16576Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER