MEDICARE: ADVANCED HOME CARE SERVICES

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

General Provider Information

NPI Number	:	1730363987
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED HOME CARE SERVICES

Provider Business Mailing Address
First Line	:	1335 S AZUSA AVE STE 216
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91792-3966
Country	:	US
Telephone Number	:	626-917-2000
Fax Number	:	626-917-2000

Provider Business Practice Location Address
First Line	:	1335 S AZUSA AVE STE 216
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91792-3966
Country	:	US
Telephone Number	:	626-917-2000
Fax Number	:	626-917-2000

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. LAGRIMAS HARO
Credential	:	RN
Telephone Number	:	626-233-8291

Provider Enumeration Date	:	12/24/2007
Last Update Date	:	12/24/2007

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