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NPI Code Detail

MEDICARE: ADVANTAGE HOME HEALTHCARE

MEDICARE: ADVANTAGE HOME HEALTHCARE
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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1952744955
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANTAGE HOME HEALTHCARE
Provider Business Mailing Address
First Line : 524 W CENTRE AVE
Second Line :
City : PORTAGE
State : MI
Zip : 49024-5306
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 524 W CENTRE AVE
Second Line :
City : PORTAGE
State : MI
Zip : 49024-5306
Country : US
Telephone Number : 269-324-1180
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : COLLEEN REISTERER
Credential :
Telephone Number : 269-324-1180
Provider Enumeration Date : 04/10/2013
Last Update Date : 04/10/2013

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Directions to “ADVANTAGE HOME HEALTHCARE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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