Provider Demographics
NPI:1962755264
Name:ACCREDITED HOME CARE
Entity type:Organization
Organization Name:ACCREDITED HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEAN SIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:ENOWACHOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-570-8295
Mailing Address - Street 1:9898 BISSONNET ST. SUITE 588
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036
Mailing Address - Country:US
Mailing Address - Phone:281-570-8295
Mailing Address - Fax:713-771-1958
Practice Address - Street 1:9898 BISSONNET ST STE 588
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8280
Practice Address - Country:US
Practice Address - Phone:281-570-8295
Practice Address - Fax:713-771-1958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities