Provider Demographics
NPI:1104602317
Name:ACORN HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:ACORN HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MGR/DON
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DESTOUT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:239-677-8509
Mailing Address - Street 1:612 SE 27TH ST
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-2820
Mailing Address - Country:US
Mailing Address - Phone:239-677-8509
Mailing Address - Fax:
Practice Address - Street 1:612 SE 27TH ST
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-2820
Practice Address - Country:US
Practice Address - Phone:239-677-8509
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-04
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health