Provider Demographics
NPI:1801102843
Name:ACORN ELDER CARE LLC
Entity type:Organization
Organization Name:ACORN ELDER CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:KIGHT
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-221-1698
Mailing Address - Street 1:PO BOX 2248
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34995-2248
Mailing Address - Country:US
Mailing Address - Phone:772-221-1698
Mailing Address - Fax:772-221-1135
Practice Address - Street 1:542 SW HALPATIOKEE ST
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2816
Practice Address - Country:US
Practice Address - Phone:772-221-1698
Practice Address - Fax:772-221-1135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-27
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL231415302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization