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General NPI Number Information
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NPI Number | 1295832749
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Entity Type | Organization
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Legal Business Name | AC & JW INC.
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Dates
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Enumeration Date | 09/19/2006
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 208 W BLUFF ST STE A
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City | WOODVILLE
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State | TX
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Zip | 75979-5222
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Country | US
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Telephone | 409-283-3600
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Fax | 409-283-7126
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Provider Business Mailing Address
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Address Line | 208 W BLUFF ST STE A
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City | WOODVILLE
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State | TX
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Zip | 75979-5222
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Country | US
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Telephone | 409-283-3600
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Fax | 409-283-7126
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Authorized Official
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Title or Position | PRESIDENT, CEO
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Name | DARRYL FRESNE
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Credential |
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Telephone | 409-283-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 677428
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License Number State | TX
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