Provider Demographics
NPI:1336389394
Name:ACE HOME HEALTHCARE AGENCY, LTD
Entity Type:Organization
Organization Name:ACE HOME HEALTHCARE AGENCY, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-474-6817
Mailing Address - Street 1:2324 STANLEY AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45404-1202
Mailing Address - Country:US
Mailing Address - Phone:937-260-4256
Mailing Address - Fax:937-262-7999
Practice Address - Street 1:2324 STANLEY AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45404-1202
Practice Address - Country:US
Practice Address - Phone:937-260-4256
Practice Address - Fax:937-262-7999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health