Provider Demographics
NPI:1699026989
Name:ACCLAIM HOMECARE SVC LLC
Entity Type:Organization
Organization Name:ACCLAIM HOMECARE SVC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FUNMILAYO
Authorized Official - Middle Name:O
Authorized Official - Last Name:AKINTADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-690-1011
Mailing Address - Street 1:2401 AVE J SUITE 221A
Mailing Address - Street 2:SUITE 221A
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006
Mailing Address - Country:US
Mailing Address - Phone:817-608-0088
Mailing Address - Fax:817-608-0099
Practice Address - Street 1:2401 AVE J SUITE 221A
Practice Address - Street 2:SUITE 221A
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006
Practice Address - Country:US
Practice Address - Phone:817-608-0088
Practice Address - Fax:817-608-0099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-26
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX407167201Medicaid