Organization
ABILITY CLUB CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WADE MITCHELL OGLETREE MS (CEO)
(251) 404-0016
Entity
Organization
Contact information
Practice address
11551 PINE DR, GULFPORT, MS 39503-3998
(251) 404-0016
Mailing address
11551 PINE DR, GULFPORT, MS 39503-3998
(251) 404-0016
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/27/2014
Last updated
10/27/2014
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