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General NPI Number Information
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NPI Number | 1356829105
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Entity Type | Organization
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Legal Business Name | 5TH GENERATION INC D/B/A ACTI-KARE RESPONSIVE IN-HOME CARE
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Dates
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Enumeration Date | 08/03/2018
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Last Update Date | 05/23/2019
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Provider Practice Location Address
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Address Line | 9050 PINES BLVD STE 415-409
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6455
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Country | US
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Telephone | 954-272-6103
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Fax | 954-637-1888
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Provider Business Mailing Address
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Address Line | 9050 PINES BLVD STE 415-409
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6455
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Country | US
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Telephone | 954-272-6103
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Fax | 954-637-1888
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Authorized Official
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Title or Position | AREA DIRECTOR
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Name | INDRA CAMPBELL
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Credential |
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Telephone | 954-272-6103
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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 | 29994797
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License Number State | FL
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