Provider Demographics
NPI:1427073493
Name:ACE HOMECARE LLC
Entity type:Organization
Organization Name:ACE HOMECARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CIO
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:S
Authorized Official - Last Name:BARLAAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-621-0020
Mailing Address - Street 1:PO BOX 2261
Mailing Address - Street 2:
Mailing Address - City:MANGO
Mailing Address - State:FL
Mailing Address - Zip Code:33550-2261
Mailing Address - Country:US
Mailing Address - Phone:813-621-0020
Mailing Address - Fax:813-621-0022
Practice Address - Street 1:3656 INNOVATION DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33812-4105
Practice Address - Country:US
Practice Address - Phone:863-644-1968
Practice Address - Fax:863-644-7950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992170251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108191Medicare ID - Type UnspecifiedPROVIDER NUMBER