Basic Information
| Provider Information | |||||||||
| NPI: | 1134638455 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ABILITIES UNITED | ||||||||
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| Mailing Information | |||||||||
| Address1: | 525 E CHARLESTON RD | ||||||||
| Address2: | |||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943064247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6504940550 | ||||||||
| FaxNumber: | 6508559710 | ||||||||
| Practice Location | |||||||||
| Address1: | 3864 MIDDLEFIELD RD | ||||||||
| Address2: | |||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943034716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6504940550 | ||||||||
| FaxNumber: | 6508559710 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/29/2017 | ||||||||
| LastUpdateDate: | 09/29/2017 | ||||||||
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| AuthorizedOfficialLastName: | WEIDANZ | ||||||||
| AuthorizedOfficialFirstName: | CHARLIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF EXECUTIVE OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 6506183312 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251P0200X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | 225XP0200X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | 235Z00000X | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.