Healthcare Provider Details

I. General information

NPI: 1558064865
Provider Name (Legal Business Name): ABLE REHAB STAFFING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 06/07/2023
Certification Date: 06/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14042 COOK ST
THORNTON CO
80602-8886
US

IV. Provider business mailing address

14042 COOK ST
THORNTON CO
80602-8886
US

V. Phone/Fax

Practice location:
  • Phone: 763-229-7105
  • Fax:
Mailing address:
  • Phone: 763-229-7105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: KELLY FOX
Title or Position: DIRECTOR
Credential:
Phone: 763-229-7105