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General NPI Number Information
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NPI Number | 1003183690
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Entity Type | Organization
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Legal Business Name | ABILITY ENHANCEMENT RESOURCES
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Dates
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Enumeration Date | 11/26/2011
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Last Update Date | 11/26/2011
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Provider Practice Location Address
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Address Line | 1906 W GROUSE ST
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City | NAMPA
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State | ID
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Zip | 83651-8340
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Country | US
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Telephone | 208-442-0325
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Fax | 208-442-5271
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Provider Business Mailing Address
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Address Line | 1906 W GROUSE ST
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City | NAMPA
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State | ID
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Zip | 83651-8340
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Country | US
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Telephone | 208-442-0325
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Fax | 208-442-5271
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Authorized Official
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Title or Position | ADMINISTRATOR/OWNER
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Name | MICHELLE A MITTON
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Credential | B.S.
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Telephone | 208-442-0325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | A0000749
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License Number State | ID
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