NPIMap

Organization Active NPI

Acl Home Care LLC

  • In Home Supportive Care Agency
  • Portage, IN
National Provider Identifier
1699054080
Registry record updated Jan 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
ACL HOME CARE LLC
Practice address
5835 Jessica Ave
Portage, IN 46368-1662
Phone
(219) 796-7035
NPI assigned
Aug 16, 2011
Last updated
Jan 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Terria ConwellNPI 1982243408
Title
Owner/Administrator
Phone
(219) 628-5672

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X NU Primary

Addresses

Primary practice location

5835 Jessica Ave
Portage, IN 46368-1662

Mailing address

6111 Harrison St
Suite 104
Merrillville, IN 46410-2969
Phone (219) 951-0281

Other identifiers 1

IdentifierTypeStateIssuer
300019795MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@aclindiana.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Acl Home Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578096000000",
    "number": "1699054080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6111 HARRISON ST",
            "address_2": "SUITE 104",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464102969",
            "telephone_number": "219-951-0281",
            "fax_number": "219-951-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5835 JESSICA AVE",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463681662",
            "telephone_number": "219-796-7035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACL HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-16",
        "last_updated": "2020-01-04",
        "certification_date": "2020-01-04",
        "status": "A",
        "authorized_official_last_name": "CONWELL",
        "authorized_official_first_name": "TERRIA",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "219-628-5672"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300019795",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@aclindiana.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5835 Jessica Ave",
            "city": "Portage",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463681662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portage, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.