Healthcare Provider Details

I. General information

NPI: 1740242718
Provider Name (Legal Business Name): ACCENTCARE HOME HEALTH OF CALIFORNIA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 03/20/2020
Certification Date: 03/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2344 S 2ND ST STE A
EL CENTRO CA
92243-5606
US

IV. Provider business mailing address

17855 N. DALLAS PKWY. SUITE 200
DALLAS TX
75287-6857
US

V. Phone/Fax

Practice location:
  • Phone: 760-352-4022
  • Fax:
Mailing address:
  • Phone: 972-267-1100
  • Fax: 972-267-1116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number08-000479
License Number StateCA

VIII. Authorized Official

Name: REENE COWAN
Title or Position: PARALEGAL
Credential:
Phone: 972-201-3779