Provider Demographics
NPI:1932829231
Name:ACLS HOMECARE AGENCY LLC
Entity Type:Organization
Organization Name:ACLS HOMECARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / VICE PRESIDENT / ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:LEANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-396-6050
Mailing Address - Street 1:1425 E DUBLIN GRANVILLE RD STE 109B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-3312
Mailing Address - Country:US
Mailing Address - Phone:614-396-6050
Mailing Address - Fax:
Practice Address - Street 1:1425 E DUBLIN GRANVILLE RD STE 109B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-3312
Practice Address - Country:US
Practice Address - Phone:614-396-6050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care