Provider Demographics
NPI:1386043297
Name:ACROVITA, LLC
Entity Type:Organization
Organization Name:ACROVITA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:TRUEMAN
Authorized Official - Last Name:FUEHNE
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:314-517-1284
Mailing Address - Street 1:PO BOX 410171
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-0171
Mailing Address - Country:US
Mailing Address - Phone:314-517-1284
Mailing Address - Fax:314-432-5382
Practice Address - Street 1:11721 SUMMERHAVEN DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-5443
Practice Address - Country:US
Practice Address - Phone:314-517-1284
Practice Address - Fax:314-432-5382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001028985251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health