Provider Demographics
NPI:1932815867
Name:ABLE ASSISTED LLC
Entity Type:Organization
Organization Name:ABLE ASSISTED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEETRA
Authorized Official - Middle Name:ROCHELLE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-498-4024
Mailing Address - Street 1:401 TOM LANDRY HWY # 224774
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75260-9990
Mailing Address - Country:US
Mailing Address - Phone:469-848-4632
Mailing Address - Fax:
Practice Address - Street 1:581 SHERWOOD LN
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:TX
Practice Address - Zip Code:75840-1917
Practice Address - Country:US
Practice Address - Phone:469-848-4632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility