Provider Demographics
NPI:1891715710
Name:ACTION HOME CARE INC.
Entity Type:Organization
Organization Name:ACTION HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:HAZEL
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:863-680-2273
Mailing Address - Street 1:PO BOX 2727
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33806-2727
Mailing Address - Country:US
Mailing Address - Phone:863-680-2273
Mailing Address - Fax:863-687-3867
Practice Address - Street 1:1645 LAKELAND HILLS BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-3025
Practice Address - Country:US
Practice Address - Phone:863-680-2273
Practice Address - Fax:863-687-3867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL200780961251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650360800Medicaid