Healthcare Provider Details

I. General information

NPI: 1558672899
Provider Name (Legal Business Name): UNLIMITED ABILITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2010
Last Update Date: 07/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5603 RED CRESTED WAY
LOUISVILLE KY
40218-5008
US

IV. Provider business mailing address

5603 RED CRESTED WAY
LOUISVILLE KY
40218-5008
US

V. Phone/Fax

Practice location:
  • Phone: 502-718-1168
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. YLONDA DAVIS
Title or Position: CHAIRMAN/CEO
Credential:
Phone: 502-718-1168