Provider Demographics
NPI:1417246679
Name:ACCENTCARE, INC.
Entity Type:Organization
Organization Name:ACCENTCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CONTRACT
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:ENTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-623-1542
Mailing Address - Street 1:135 TECHNOLOGY DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2466
Mailing Address - Country:US
Mailing Address - Phone:949-623-1500
Mailing Address - Fax:949-623-1542
Practice Address - Street 1:2802 S 1ST ST
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75901-7108
Practice Address - Country:US
Practice Address - Phone:936-632-4349
Practice Address - Fax:936-632-0063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-28
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007744251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679108Medicare Oscar/Certification