Provider Demographics
NPI:1538599410
Name:ACG-CARE SERVICES LLC
Entity type:Organization
Organization Name:ACG-CARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:LONDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-266-6402
Mailing Address - Street 1:5607 DEANE AVE
Mailing Address - Street 2:LOS ANGELES
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90043-2344
Mailing Address - Country:US
Mailing Address - Phone:310-208-7765
Mailing Address - Fax:
Practice Address - Street 1:947 TIVERTON AVE
Practice Address - Street 2:#533
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-3012
Practice Address - Country:US
Practice Address - Phone:310-208-7765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care