MEDICARE: ACCELERATED HOMECARE SERVICES, INC.

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	374U00000X	Home Health Aide
2	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598743205
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCELERATED HOMECARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	17520 W 12 MILE RD STE 100
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-1943
Country	:	US
Telephone Number	:	248-281-6880
Fax Number	:	248-281-6871

Provider Business Practice Location Address
First Line	:	17520 W 12 MILE RD STE 100
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-1943
Country	:	US
Telephone Number	:	248-281-6880
Fax Number	:	248-281-6871

Authorized Official
Title or Position	:	DIRECTOR OF NURSING
Name	:	MS. ADELINA BASTE MCCAULLEY
Credential	:	REGISTERD NURSE
Telephone Number	:	248-866-3877

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	10/12/2023

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