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General NPI Number Information
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NPI Number | 1629118971
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Entity Type | Organization
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Legal Business Name | A.C.T. HEALTHCARE SUPPORT SERVICES, INC
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2105 PARK ST SUITE D
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City | JACKSONVILLE
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State | FL
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Zip | 32204-3811
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Country | US
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Telephone | 904-388-5413
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Fax | 904-388-5537
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Provider Business Mailing Address
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Address Line | 318 WILDBERRY CT
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City | ORANGE PARK
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State | FL
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Zip | 32073-2254
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Country | US
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Telephone | 904-210-5643
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Fax | 904-908-9749
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Authorized Official
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Title or Position | CEO
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Name | MR. AARON COLUMBUS THURMOND JR.
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Credential |
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Telephone | 904-210-5346
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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 |
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License Number State |
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