Provider Demographics
NPI:1235230665
Name:AC HOMENURSING SERVICES
Entity Type:Organization
Organization Name:AC HOMENURSING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-393-4663
Mailing Address - Street 1:2921 YOUNGSTOWN RD SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-5260
Mailing Address - Country:US
Mailing Address - Phone:330-393-4663
Mailing Address - Fax:
Practice Address - Street 1:2921 YOUNGSTOWN RD SE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-5260
Practice Address - Country:US
Practice Address - Phone:330-393-4663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0933137Medicaid
PA01533513Medicaid
OH367522Medicare ID - Type Unspecified
OH0933137Medicaid