Healthcare Provider Details

I. General information

NPI: 1801102843
Provider Name (Legal Business Name): ACORN ELDER CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2010
Last Update Date: 10/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

542 SW HALPATIOKEE ST
STUART FL
34994-2816
US

IV. Provider business mailing address

PO BOX 2248
STUART FL
34995-2248
US

V. Phone/Fax

Practice location:
  • Phone: 772-221-1698
  • Fax: 772-221-1135
Mailing address:
  • Phone: 772-221-1698
  • Fax: 772-221-1135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number231415
License Number StateFL

VIII. Authorized Official

Name: MRS. JANET KIGHT PORTER
Title or Position: PRESIDENT
Credential:
Phone: 772-221-1698