Healthcare Provider Details

I. General information

NPI: 1326184516
Provider Name (Legal Business Name): ABILITIES PLUS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 N EAST ST
KEWANEE IL
61443-1133
US

IV. Provider business mailing address

1100 N EAST ST
KEWANEE IL
61443-1133
US

V. Phone/Fax

Practice location:
  • Phone: 309-852-4626
  • Fax: 309-852-0805
Mailing address:
  • Phone: 309-852-4626
  • Fax: 309-852-0805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: TRACY I. HURLEY
Title or Position: BUSINESS MANAGER
Credential:
Phone: 309-852-4626