Provider Demographics
NPI:1154952422
Name:ACTI-KARE
Entity type:Organization
Organization Name:ACTI-KARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAMIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EMERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-264-1410
Mailing Address - Street 1:4804 ROYAHN AVE
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-3819
Mailing Address - Country:US
Mailing Address - Phone:443-854-0301
Mailing Address - Fax:813-412-5952
Practice Address - Street 1:4804 ROYAHN AVE
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-3819
Practice Address - Country:US
Practice Address - Phone:443-854-0301
Practice Address - Fax:813-412-5952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care