Provider Demographics
NPI:1902938236
Name:DIFFERENTLY ABLED, INC.
Entity Type:Organization
Organization Name:DIFFERENTLY ABLED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMERSON
Authorized Official - Middle Name:L
Authorized Official - Last Name:STOCKS
Authorized Official - Suffix:JR
Authorized Official - Credentials:LNHA
Authorized Official - Phone:440-254-3207
Mailing Address - Street 1:13760 MAGGIE LN
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-8726
Mailing Address - Country:US
Mailing Address - Phone:440-254-3207
Mailing Address - Fax:440-254-3207
Practice Address - Street 1:13760 MAGGIE LN
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-8726
Practice Address - Country:US
Practice Address - Phone:440-254-3207
Practice Address - Fax:440-254-3207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities