Healthcare Provider Details

I. General information

NPI: 1003642968
Provider Name (Legal Business Name): ABLE LIFE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 10/04/2025
Certification Date: 10/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4808 BERGENLINE AVE STE 502
UNION CITY NJ
07087-5171
US

IV. Provider business mailing address

725 RIVER RD STE 32-189
EDGEWATER NJ
07020-1171
US

V. Phone/Fax

Practice location:
  • Phone: 718-825-8499
  • Fax:
Mailing address:
  • Phone: 718-825-8499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: CARMEN BROWN
Title or Position: CEO
Credential:
Phone: 718-825-8499