Provider Demographics
NPI:1396920260
Name:ACHIMBI ENTERPRISES, L.L.C.
Entity type:Organization
Organization Name:ACHIMBI ENTERPRISES, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:660-665-0717
Mailing Address - Street 1:608 N FRANKLIN ST
Mailing Address - Street 2:APT 1
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-2991
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:608 N FRANKLIN ST
Practice Address - Street 2:APT 1
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-2991
Practice Address - Country:US
Practice Address - Phone:660-665-0717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health