Healthcare Provider Details

I. General information

NPI: 1831425792
Provider Name (Legal Business Name): ABLE HEALTH CARE SYSTEM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2009
Last Update Date: 10/17/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6023 ARIZONA AVE
BALTIMORE MD
21206-3804
US

IV. Provider business mailing address

6023 ARIZONA AVE
BALTIMORE MD
21206-3804
US

V. Phone/Fax

Practice location:
  • Phone: 410-488-0080
  • Fax: 410-488-0729
Mailing address:
  • Phone: 410-488-0080
  • Fax: 410-488-0729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. AGNES IKUSIKA
Title or Position: DIRECTOR
Credential:
Phone: 443-522-5457