Provider Demographics
NPI:1346940194
Name:ACTION HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:ACTION HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/STATUTORY AGENT
Authorized Official - Prefix:
Authorized Official - First Name:ARIONA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-688-8637
Mailing Address - Street 1:112 N CENTRAL AVE STE M36
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-2309
Mailing Address - Country:US
Mailing Address - Phone:216-688-8637
Mailing Address - Fax:
Practice Address - Street 1:112 N CENTRAL AVE STE M36
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-2309
Practice Address - Country:US
Practice Address - Phone:216-688-8637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care