Organization
ABILITY INTERVENTIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHARLENE RICARD IP (OWNER)
(208) 553-8650
Entity
Organization
Contact information
Practice address
1215 BRYDEN AVE, LEWISTON, ID 83501-5348
(208) 553-8650
Mailing address
1215 BRYDEN AVE, LEWISTON, ID 83501-5348
(208) 553-8650
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/29/2022
Last updated
10/04/2022
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