Basic Information
| Provider Information | |||||||||
| NPI: | 1083088694 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ENABLE THERAPY SERVICES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 711 E MISSOURI AVE | ||||||||
| Address2: | SUITE 170 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850142841 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022775006 | ||||||||
| FaxNumber: | 6022775042 | ||||||||
| Practice Location | |||||||||
| Address1: | 711 E MISSOURI AVE | ||||||||
| Address2: | SUITE 170 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850142841 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022775006 | ||||||||
| FaxNumber: | 6022775042 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/19/2015 | ||||||||
| LastUpdateDate: | 11/19/2015 | ||||||||
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| AuthorizedOfficialLastName: | O'BRIEN | ||||||||
| AuthorizedOfficialFirstName: | BRIDGET | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6022775006 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | Y | Agencies | Home Health |
No ID Information.