Provider Demographics
NPI:1013757392
Name:ACT CARE LLC
Entity type:Organization
Organization Name:ACT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NASTEXO
Authorized Official - Middle Name:
Authorized Official - Last Name:AWIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-855-3937
Mailing Address - Street 1:12751 COUNTY ROAD 5 STE 105
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-2263
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12751 COUNTY ROAD 5 STE 105
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-2263
Practice Address - Country:US
Practice Address - Phone:952-855-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-25
Last Update Date:2024-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health