Provider Demographics
NPI:1811100605
Name:MAXABILITY THERAPY SERVICES, P.C.
Entity type:Organization
Organization Name:MAXABILITY THERAPY SERVICES, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELODY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHARLESON
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:402-391-5002
Mailing Address - Street 1:10909 MILL VALLEY RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154
Mailing Address - Country:US
Mailing Address - Phone:402-763-4408
Mailing Address - Fax:402-343-1278
Practice Address - Street 1:10909 MILL VALLEY RD
Practice Address - Street 2:SUITE 210
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154
Practice Address - Country:US
Practice Address - Phone:402-763-4408
Practice Address - Fax:402-343-1278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1851509582OtherBLUE CROSS AND BLUE SHIELD
NE10025887700Medicaid
NE=========00Medicaid