=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104424316
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ACUTE RESIDENTIAL CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/12/2020
-----------------------------------------------------
Last Update Date | 10/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 81 POINTE CIR STE 17D
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29615-3505
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-926-0452
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 81 POINTE CIR STE 17D
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29615-3505
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-926-0452
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | KAELAH ALEXANDER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 313-926-6452
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------