Basic Information
| Provider Information | |||||||||
| NPI: | 1144277013 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ABLE HOME HEALTH, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ALABAMA HOMECARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 51266 | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705051266 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3372331307 | ||||||||
| FaxNumber: | 3372335764 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 CENTERVIEW DR | ||||||||
| Address2: | SUITE 260 | ||||||||
| City: | VESTAVIA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352163747 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059793180 | ||||||||
| FaxNumber: | 2059793183 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2006 | ||||||||
| LastUpdateDate: | 07/26/2013 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | STELLY | ||||||||
| AuthorizedOfficialFirstName: | DONALD | ||||||||
| AuthorizedOfficialMiddleName: | D. | ||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3372331307 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | N/A | Y | Agencies | Home Health |
ID Information
| ID | Type | State | Issuer | Description | 515-41100 | 01 | AL | BLUE CROSS BLUE SHIELD OF | OTHER | ABL7041A | 05 | AL | MEDICAID | 515-41101 | 01 | AL | BLUE CROSS BLUE SHIELD OF | OTHER |