Provider Demographics
NPI:1518175405
Name:ACCENTCARE AT HOME, INC.
Entity Type:Organization
Organization Name:ACCENTCARE AT HOME, INC.
Other - Org Name:ACCENTCARE INC
Other - Org Type:Other Name
Authorized Official - Title/Position:VP/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:DENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-201-3819
Mailing Address - Street 1:17855 DALLAS PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-6857
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4001 N 3RD ST STE 410
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2086
Practice Address - Country:US
Practice Address - Phone:602-749-5559
Practice Address - Fax:602-749-5521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2022-01-04
Deactivation Date:2019-04-23
Deactivation Code:
Reactivation Date:2019-05-14
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0700004370OtherSIERRA VISTA BUSINESS LIC
AZ1128744OtherTUCSON BUSINESS LICENSE
AZ361569Medicaid