=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366611196
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ABILITY BUILDING CENTER INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/26/2008
-----------------------------------------------------
Last Update Date | 02/26/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1911 14TH ST NW
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55901-0756
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-281-6262
-----------------------------------------------------
Fax | 507-281-6270
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1911 14TH ST NW PO BOX 6938
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55901-0756
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-281-6262
-----------------------------------------------------
Fax | 507-281-6270
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ACCOUNTANT
-----------------------------------------------------
Name | KENNETH PETER KRONEBUSCH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 507-535-7112
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251C00000X
-----------------------------------------------------
Taxonomy Name | Developmentally Disabled Services Day Training Agency
-----------------------------------------------------
License Number | 800026-3-DTH
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------