Provider Demographics
NPI:1871029850
Name:ACOM HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:ACOM HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADEBUKOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OBASANYA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:972-302-4683
Mailing Address - Street 1:5900 S LAKE FOREST DR STE 300
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2238
Mailing Address - Country:US
Mailing Address - Phone:972-595-7233
Mailing Address - Fax:972-984-7896
Practice Address - Street 1:5900 S LAKE FOREST DR STE 300
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-2238
Practice Address - Country:US
Practice Address - Phone:972-595-7233
Practice Address - Fax:972-984-7896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX802709721OtherHOME HEALTHCARE AND ASSISTED LIVING