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General NPI Number Information
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NPI Number | 1780886465
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Entity Type | Organization
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Legal Business Name | 2AC HOMEHEALTHCARE
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 5737 CONSTITUTION AVE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80915-1220
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Country | US
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Telephone | 171-959-0951
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Fax | 719-535-9212
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Provider Business Mailing Address
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Address Line | 5737 CONSTITUTION AVE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80915-1220
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Country | US
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Telephone | 171-959-0951
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Fax | 719-535-9212
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ANNETTE ALICIA MOODY I
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Credential |
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Telephone | 17195909510
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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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