Healthcare Provider Details

I. General information

NPI: 1225441520
Provider Name (Legal Business Name): ABILITIES BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2014
Last Update Date: 08/25/2020
Certification Date: 08/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

357 SLOPE ST
WARRIOR RUN PA
18706
US

IV. Provider business mailing address

357 SLOPE ST
WARRIOR RUN PA
18706-1903
US

V. Phone/Fax

Practice location:
  • Phone: 773-317-4452
  • Fax:
Mailing address:
  • Phone: 773-317-4452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: REBECCA RACE
Title or Position: EXECUTIVE DIRECTOR
Credential: MA
Phone: 773-317-4452