Provider Demographics
NPI:1083045934
Name:AKULISNY ENTERPRISE LLC
Entity type:Organization
Organization Name:AKULISNY ENTERPRISE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/MGR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-645-8934
Mailing Address - Street 1:3225 GROVESHIRE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-8391
Mailing Address - Country:US
Mailing Address - Phone:919-645-8934
Mailing Address - Fax:
Practice Address - Street 1:3225 GROVESHIRE DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-8391
Practice Address - Country:US
Practice Address - Phone:919-645-8934
Practice Address - Fax:877-461-2908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care