Provider Demographics
NPI:1174590335
Name:ACCENT ON INDEPENDENCE, LLC
Entity type:Organization
Organization Name:ACCENT ON INDEPENDENCE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-331-0818
Mailing Address - Street 1:1550 DOVER ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-3106
Mailing Address - Country:US
Mailing Address - Phone:303-331-0818
Mailing Address - Fax:303-321-3015
Practice Address - Street 1:1550 DOVER ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-3106
Practice Address - Country:US
Practice Address - Phone:303-331-0818
Practice Address - Fax:303-321-3015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10E991253Z00000X
376J00000X, 385H00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO80525245Medicaid
CO05701016Medicaid
CO51339862Medicaid
CO067101Medicare PIN