Healthcare Provider Details

I. General information

NPI: 1114164308
Provider Name (Legal Business Name): AADVANCE HOME HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2009
Last Update Date: 07/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 N ROLLING RD SUITE# 303
CATONSVILLE MD
21228-4140
US

IV. Provider business mailing address

516 N ROLLING RD SUITE# 303
CATONSVILLE MD
21228-4142
US

V. Phone/Fax

Practice location:
  • Phone: 410-744-8200
  • Fax: 410-744-8203
Mailing address:
  • Phone: 410-744-8200
  • Fax: 410-744-8203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ELKEN BANSAH SR.
Title or Position: ADMINISTRATOR
Credential:
Phone: 410-744-8200