Provider Demographics
NPI:1811902299
Name:A & C HEALTHCARE SERVICES, INC.
Entity type:Organization
Organization Name:A & C HEALTHCARE SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MANEESH
Authorized Official - Middle Name:
Authorized Official - Last Name:BANSAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-924-9618
Mailing Address - Street 1:1331 CAMDEN AVENUE
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-6701
Mailing Address - Country:US
Mailing Address - Phone:408-377-4030
Mailing Address - Fax:408-369-0308
Practice Address - Street 1:1331 CAMDEN AVENUE
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-6701
Practice Address - Country:US
Practice Address - Phone:408-377-4030
Practice Address - Fax:408-369-0308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA070000020314000000X
CA314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZR184391Medicaid
CA555838Medicare Oscar/Certification