=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790648715
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ENHANCING ABILITIES BEHAVIORAL AND DAY SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/05/2025
-----------------------------------------------------
Last Update Date | 12/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 113 S PERRY ST STE 20613908
-----------------------------------------------------
City | LAWRENCEVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30046-4811
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-509-5296
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 113 S PERRY ST STE 20613908
-----------------------------------------------------
City | LAWRENCEVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30046-4811
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-509-5296
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/OWNER
-----------------------------------------------------
Name | TIFFANY SMITH
-----------------------------------------------------
Credential | MS
-----------------------------------------------------
Telephone | 317-457-8844
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------