Provider Demographics
NPI:1740840925
Name:INFINITE ABILITIES & SUPPORTS, INC.
Entity type:Organization
Organization Name:INFINITE ABILITIES & SUPPORTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-271-6446
Mailing Address - Street 1:4740 N HIGHWAY 27
Mailing Address - Street 2:
Mailing Address - City:SCIENCE HILL
Mailing Address - State:KY
Mailing Address - Zip Code:42553-9342
Mailing Address - Country:US
Mailing Address - Phone:606-271-6446
Mailing Address - Fax:
Practice Address - Street 1:2012 N HIGHWAY 1247
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-4601
Practice Address - Country:US
Practice Address - Phone:606-271-6446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities