Provider Demographics
NPI:1750578373
Name:ABIDE WITH ME, LLC
Entity type:Organization
Organization Name:ABIDE WITH ME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLEE
Authorized Official - Middle Name:SUZAN
Authorized Official - Last Name:WUERTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-263-0088
Mailing Address - Street 1:155 S LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LESLIE
Mailing Address - State:MO
Mailing Address - Zip Code:63056-2404
Mailing Address - Country:US
Mailing Address - Phone:573-263-0088
Mailing Address - Fax:636-583-3017
Practice Address - Street 1:155 S LAKE DR
Practice Address - Street 2:
Practice Address - City:LESLIE
Practice Address - State:MO
Practice Address - Zip Code:63056-2404
Practice Address - Country:US
Practice Address - Phone:573-263-0088
Practice Address - Fax:636-583-3017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities