Provider Demographics
NPI:1609407733
Name:ACTI-KARE
Entity Type:Organization
Organization Name:ACTI-KARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-652-3959
Mailing Address - Street 1:5587 ORCHARD CV
Mailing Address - Street 2:
Mailing Address - City:MINNETRISTA
Mailing Address - State:MN
Mailing Address - Zip Code:55364-1292
Mailing Address - Country:US
Mailing Address - Phone:952-209-1356
Mailing Address - Fax:813-412-5952
Practice Address - Street 1:5587 ORCHARD CV
Practice Address - Street 2:
Practice Address - City:MINNETRISTA
Practice Address - State:MN
Practice Address - Zip Code:55364-1292
Practice Address - Country:US
Practice Address - Phone:952-209-1356
Practice Address - Fax:813-412-5952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-28
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care