MEDICARE: A&C HOMECARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency	NONE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316268279
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A&C HOMECARE

Provider Business Mailing Address
First Line	:	5764 RIDGE DR
Second Line	:
City	:	SANTA TERESA
State	:	NM
Zip	:	88008-9529
Country	:	US
Telephone Number	:	575-578-9555
Fax Number	:	505-883-3610

Provider Business Practice Location Address
First Line	:	5764 RIDGE DR
Second Line	:
City	:	SANTA TERESA
State	:	NM
Zip	:	88008-9529
Country	:	US
Telephone Number	:	575-578-9555
Fax Number	:	505-883-3610

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SUSANA CALDERON
Credential	:
Telephone Number	:	575-578-9555

Provider Enumeration Date	:	06/15/2010
Last Update Date	:	06/15/2010

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Directions to “A&C HOMECARE ” Practice Location

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