Provider Demographics
NPI:1578891552
Name:ACESO, LLC
Entity Type:Organization
Organization Name:ACESO, LLC
Other - Org Name:ACESO
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DOWDY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:812-449-5903
Mailing Address - Street 1:PO BOX 578
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47629-0578
Mailing Address - Country:US
Mailing Address - Phone:812-449-5903
Mailing Address - Fax:812-853-9174
Practice Address - Street 1:7899 BELL OAKS DR
Practice Address - Street 2:#3
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-2579
Practice Address - Country:US
Practice Address - Phone:812-449-5903
Practice Address - Fax:812-853-9174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-02
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN09-012232-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200972490Medicaid
IN200972490Medicaid