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General NPI Number Information
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NPI Number | 1861305666
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Entity Type | Organization
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Legal Business Name | ENABLED LLC
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Dates
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Enumeration Date | 09/24/2026
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Last Update Date | 09/24/2026
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Provider Practice Location Address
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Address Line | 104 HAUGHTON AVE
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City | HUEYTOWN
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State | AL
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Zip | 35023-2432
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Country | US
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Telephone | 205-565-7114
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Fax |
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Provider Business Mailing Address
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Address Line | 7400 LAKE IN THE WOODS LN
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City | TRUSSVILLE
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State | AL
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Zip | 35173-2772
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Country | US
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Telephone | 727-255-4412
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. DERRICK D WILLIAMS
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Credential |
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Telephone | 727-255-4412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State |
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