Provider Demographics
NPI:1952788309
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:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS-ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-969-0208
Mailing Address - Street 1:5861 SIR HENRY RD
Mailing Address - Street 2:ORLANDO
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:2015-05-05
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299994742251E00000X
FL232748253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013468000Medicaid