Provider Demographics
NPI:1295464147
Name:ACCENTUS HEALTH LLC
Entity Type:Organization
Organization Name:ACCENTUS HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-474-2150
Mailing Address - Street 1:5128 E STOP 11 RD STE 34
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-6338
Mailing Address - Country:US
Mailing Address - Phone:317-721-4169
Mailing Address - Fax:463-777-5840
Practice Address - Street 1:5128 E STOP 11 RD STE 34
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-6338
Practice Address - Country:US
Practice Address - Phone:317-721-4169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-07
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty