MEDICARE: ACCENTCARE PROVIDER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1114679693
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCENTCARE PROVIDER LLC

Provider Business Mailing Address
First Line	:	2990 RICHMOND AVE STE 525
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-3146
Country	:	US
Telephone Number	:	713-393-7520
Fax Number	:	832-218-2730

Provider Business Practice Location Address
First Line	:	2990 RICHMOND AVE STE 525
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-3146
Country	:	US
Telephone Number	:	713-393-7520
Fax Number	:	832-218-2730

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	SEUN SOLESI
Credential	:
Telephone Number	:	773-225-9417

Provider Enumeration Date	:	01/25/2022
Last Update Date	:	05/13/2022

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