MEDICARE: ACKNA HOME HEALTH AND CASE MANAGEMENT SERVICES, LLC

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

General Provider Information

NPI Number	:	1376376046
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACKNA HOME HEALTH AND CASE MANAGEMENT SERVICES, LLC

Provider Business Mailing Address
First Line	:	1015 SANDTRAP WAY
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27703-6581
Country	:	US
Telephone Number	:	984-317-9965
Fax Number	:

Provider Business Practice Location Address
First Line	:	3201 YORKTOWN AVE STE 113
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27713-3455
Country	:	US
Telephone Number	:	984-317-9965
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	ZIPORA TATE
Credential	:
Telephone Number	:	984-317-9965

Provider Enumeration Date	:	08/20/2024
Last Update Date	:	08/20/2024

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