Provider Demographics
NPI:1700142874
Name:ACH, LLC
Entity Type:Organization
Organization Name:ACH, LLC
Other - Org Name:A CARING HAND HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:J
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-253-1265
Mailing Address - Street 1:1204 W SOUTH JORDAN PKWY STE C
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-4612
Mailing Address - Country:US
Mailing Address - Phone:801-253-1265
Mailing Address - Fax:801-253-8208
Practice Address - Street 1:1204 W SOUTH JORDAN PKWY STE C
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-4612
Practice Address - Country:US
Practice Address - Phone:801-253-1265
Practice Address - Fax:801-253-8208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2011-HHA-97387251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========002OtherSALT LAKE COUNTY AGING WAIVER
UT=========001Medicaid