Provider Demographics
NPI:1720145378
Name:ACUMEN FISCAL AGENT LLC
Entity Type:Organization
Organization Name:ACUMEN FISCAL AGENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:J
Authorized Official - Last Name:AUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-211-3738
Mailing Address - Street 1:5416 E BASELINE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4704
Mailing Address - Country:US
Mailing Address - Phone:480-295-3328
Mailing Address - Fax:480-339-2123
Practice Address - Street 1:5416 E BASELINE RD STE 200
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4704
Practice Address - Country:US
Practice Address - Phone:480-295-3328
Practice Address - Fax:480-339-2123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty
No251J00000XAgenciesNursing Care
No251X00000XAgenciesSupports Brokerage
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY116315900Medicaid
GA3236199AMedicaid
GA717669748BMedicaid
GA717669748GMedicaid
GA717669748CMedicaid
GA717669748IMedicaid
GA717669748AMedicaid
GA717669748EMedicaid
GA3240064AMedicaid
GA717669748DMedicaid
GA717669748FMedicaid
GA717669748HMedicaid
UT=========006Medicaid