Provider Demographics
NPI:1588841571
Name:ACLARIS HOME HEALTH, LLC.
Entity Type:Organization
Organization Name:ACLARIS HOME HEALTH, LLC.
Other - Org Name:ACLARIS GROUP HOME, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CLARISVEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALBIZU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-935-4790
Mailing Address - Street 1:3430 W. LAMBRIGHT ST. SUITE 103
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614
Mailing Address - Country:US
Mailing Address - Phone:813-935-4790
Mailing Address - Fax:813-217-9671
Practice Address - Street 1:3430 W. LAMBRIGHT ST. SUITE 103
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614
Practice Address - Country:US
Practice Address - Phone:813-935-4790
Practice Address - Fax:813-217-9671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
FL299993524251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL682105796Medicaid
FL142755500Medicaid
FL682105798Medicaid
FL682105795Medicaid
FL682105796Medicaid