MEDICARE: ACE HOMECARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	299992170	FL

General Provider Information

NPI Number	:	1427073493
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACE HOMECARE LLC

Provider Business Mailing Address
First Line	:	PO BOX 2261
Second Line	:
City	:	MANGO
State	:	FL
Zip	:	33550-2261
Country	:	US
Telephone Number	:	813-621-0020
Fax Number	:	813-621-0022

Provider Business Practice Location Address
First Line	:	3656 INNOVATION DR
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33812-4105
Country	:	US
Telephone Number	:	863-644-1968
Fax Number	:	863-644-7950

Authorized Official
Title or Position	:	CIO
Name	:	ARTHUR S BARLAAN
Credential	:
Telephone Number	:	813-621-0020

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	04/22/2008

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