Provider Demographics
NPI:1740242718
Name:ACCENTCARE HOME HEALTH OF CALIFORNIA, INC
Entity Type:Organization
Organization Name:ACCENTCARE HOME HEALTH OF CALIFORNIA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARALEGAL
Authorized Official - Prefix:
Authorized Official - First Name:REENE
Authorized Official - Middle Name:
Authorized Official - Last Name:COWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-201-3779
Mailing Address - Street 1:17855 N. DALLAS PKWY.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-6857
Mailing Address - Country:US
Mailing Address - Phone:972-267-1100
Mailing Address - Fax:972-267-1116
Practice Address - Street 1:2344 S 2ND ST STE A
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-5606
Practice Address - Country:US
Practice Address - Phone:760-352-4022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA08-000479251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA70195GOtherMEDI-CAL
557425Medicare Oscar/Certification
557425Medicare Oscar/Certification