| Ability Club Corporation | |
|
11551 Pine Dr Gulfport MS 39503-3998 | |
| (251) 404-0016 | |
| Not Available |
| Full Name | Ability Club Corporation |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 11551 Pine Dr, Gulfport, Mississippi |
| Authorized Official Name and Position | Wade Mitchell Ogletree (CEO) |
| Authorized Official Contact | 2514040016 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ability Club Corporation 11551 Pine Dr Gulfport MS 39503-3998 Ph: (251) 404-0016 | Ability Club Corporation 11551 Pine Dr Gulfport MS 39503-3998 Ph: (251) 404-0016 |
| NPI Number | 1275938763 |
|---|---|
| Provider Enumeration Date | 10/27/2014 |
| Last Update Date | 10/27/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275938763 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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