Provider Demographics
NPI:1629570940
Name:ACCOLADE HEALTH CARE SERVICES LLC
Entity Type:Organization
Organization Name:ACCOLADE HEALTH CARE SERVICES LLC
Other - Org Name:ACCOLADE HEALTH CARE SERVICES LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS-ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-781-7804
Mailing Address - Street 1:5861 SIR HENRY RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-3320
Mailing Address - Country:US
Mailing Address - Phone:407-781-7804
Mailing Address - Fax:
Practice Address - Street 1:933 LEE RD STE 408
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-5537
Practice Address - Country:US
Practice Address - Phone:407-969-0208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-02
Last Update Date:2021-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299994742251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013468000Medicaid