Provider Demographics
NPI:1831425792
Name:ABLE HEALTH CARE SYSTEM INC
Entity type:Organization
Organization Name:ABLE HEALTH CARE SYSTEM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:
Authorized Official - Last Name:IKUSIKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-522-5457
Mailing Address - Street 1:6023 ARIZONA AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-3804
Mailing Address - Country:US
Mailing Address - Phone:410-488-0080
Mailing Address - Fax:410-488-0729
Practice Address - Street 1:6023 ARIZONA AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-3804
Practice Address - Country:US
Practice Address - Phone:410-488-0080
Practice Address - Fax:410-488-0729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-28
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251J00000XAgenciesNursing Care
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD55-2222-600Medicaid