Basic Information
| Provider Information | |||||||||
| NPI: | 1437584554 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADVANTAGE HOME CARE MANAGEMENT INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17515 W 9 MILE RD | ||||||||
| Address2: | STE 980 | ||||||||
| City: | SOUTHFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480754403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2485698400 | ||||||||
| FaxNumber: | 2485695070 | ||||||||
| Practice Location | |||||||||
| Address1: | 17515 W 9 MILE RD | ||||||||
| Address2: | STE 980 | ||||||||
| City: | SOUTHFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480754403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2485698400 | ||||||||
| FaxNumber: | 2485695070 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2013 | ||||||||
| LastUpdateDate: | 09/09/2013 | ||||||||
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| AuthorizedOfficialLastName: | HASTINGS | ||||||||
| AuthorizedOfficialFirstName: | KELSEY | ||||||||
| AuthorizedOfficialMiddleName: | KATHLEEN | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 2485698400 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | RN | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | Y | Agencies | Home Health |
No ID Information.