MEDICARE: ACN NURSING SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	251B00000X	Case Management Agency	ID
2	251J00000X	Nursing Care Agency	ID
3	347C00000X	Private Vehicle	ID
4	251E00000X	Home Health Agency	ID

General Provider Information

NPI Number	:	1982851218
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACN NURSING SERVICES, INC.

Provider Business Mailing Address
First Line	:	30721 N OSPREY RD
Second Line	:
City	:	SPIRIT LAKE
State	:	ID
Zip	:	83869-9756
Country	:	US
Telephone Number	:	208-660-4831
Fax Number	:

Provider Business Practice Location Address
First Line	:	30721 N OSPREY RD
Second Line	:
City	:	SPIRIT LAKE
State	:	ID
Zip	:	83869-9756
Country	:	US
Telephone Number	:	208-660-4831
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	WILLIAM BALLINGER JR.
Credential	:
Telephone Number	:	208-660-4831

Provider Enumeration Date	:	08/18/2008
Last Update Date	:	08/26/2008

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