Provider Demographics
NPI:1649906967
Name:ATLANTIC CARE HOME HEALTH CLERMONT LLC
Entity type:Organization
Organization Name:ATLANTIC CARE HOME HEALTH CLERMONT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF NEW MARKETS
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:407-739-7043
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:407-484-2972
Mailing Address - Fax:407-559-8971
Practice Address - Street 1:15430 COUNTY ROAD 565A STE P
Practice Address - Street 2:
Practice Address - City:GROVELAND
Practice Address - State:FL
Practice Address - Zip Code:34736-8243
Practice Address - Country:US
Practice Address - Phone:407-484-2972
Practice Address - Fax:407-559-8971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-28
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty