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General NPI Number Information
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NPI Number | 1578354726
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Entity Type | Organization
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Legal Business Name | ABILITIES UNLOCKED
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Dates
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Enumeration Date | 05/16/2025
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 10816 BURBANK BLVD
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91601-2519
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Country | US
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Telephone | 323-377-7203
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 882125
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City | LOS ANGELES
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State | CA
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Zip | 90009-3022
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Country | US
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Telephone | 323-377-7203
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | RENADDA WIGGINS
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Credential |
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Telephone | 323-377-7203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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