Provider Demographics
NPI:1164139077
Name:AXXESS HOME HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:AXXESS HOME HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:SHAWNAKAY
Authorized Official - Last Name:COSTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:347-777-7997
Mailing Address - Street 1:1577 NW 91ST AVE APT 122
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-6654
Mailing Address - Country:US
Mailing Address - Phone:347-777-7997
Mailing Address - Fax:
Practice Address - Street 1:2800 W OAKLAND PARK BLVD STE 209B
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33311-1361
Practice Address - Country:US
Practice Address - Phone:347-777-7997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TC HOPE IN CARE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health