Provider Demographics
NPI:1407536469
Name:ATLANTIC CARE HOME HEALTH WEST PALM BEACH LLC
Entity Type:Organization
Organization Name:ATLANTIC CARE HOME HEALTH WEST PALM BEACH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEW MARKET MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-935-5867
Mailing Address - Street 1:1845 OAK LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1533
Mailing Address - Country:US
Mailing Address - Phone:407-270-5501
Mailing Address - Fax:407-559-8971
Practice Address - Street 1:10570 S FEDERAL HWY STE 300
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5606
Practice Address - Country:US
Practice Address - Phone:407-270-5501
Practice Address - Fax:407-559-8971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health