Provider Demographics
NPI:1699163915
Name:ACT HEALTHCARE
Entity type:Organization
Organization Name:ACT HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNYBETH
Authorized Official - Middle Name:
Authorized Official - Last Name:DIEGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-319-0635
Mailing Address - Street 1:108 DEAN DR
Mailing Address - Street 2:UNIT 2
Mailing Address - City:SANTA PAULA
Mailing Address - State:CA
Mailing Address - Zip Code:93060-2546
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:108 DEAN DR
Practice Address - Street 2:UNIT 2
Practice Address - City:SANTA PAULA
Practice Address - State:CA
Practice Address - Zip Code:93060-2546
Practice Address - Country:US
Practice Address - Phone:909-319-0635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health