MEDICARE: ASSURED INDEPENDENCE CONSULTANTS 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	251E00000X	Home Health Agency
2	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1972857621
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSURED INDEPENDENCE CONSULTANTS LLC

Provider Business Mailing Address
First Line	:	10410 BELVAMERA RD
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-2730
Country	:	US
Telephone Number	:	281-406-0883
Fax Number	:	480-287-8372

Provider Business Practice Location Address
First Line	:	10410 BELVAMERA RD
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-2730
Country	:	US
Telephone Number	:	281-406-0883
Fax Number	:	480-287-8372

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. CHIMIRI C. DUNCAN
Credential	:	MBA
Telephone Number	:	281-406-0883

Provider Enumeration Date	:	11/02/2012
Last Update Date	:	03/07/2013

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