Healthcare Provider Details

I. General information

NPI: 1467739201
Provider Name (Legal Business Name): ALL CARE HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2011
Last Update Date: 11/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7894 NEW DELAWARE RD
MOUNT VERNON OH
43050-9159
US

IV. Provider business mailing address

7894 NEW DELAWARE RD
MOUNT VERNON OH
43050-9159
US

V. Phone/Fax

Practice location:
  • Phone: 740-507-8124
  • Fax:
Mailing address:
  • Phone: 740-507-8124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License NumberRN243819
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberRN243819
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberRN243819
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberRN243819
License Number StateOH

VIII. Authorized Official

Name: MRS. LAURA A JACKSON
Title or Position: MEMBER
Credential: RN
Phone: 740-507-8124