Healthcare Provider Details

I. General information

NPI: 1366710337
Provider Name (Legal Business Name): ADVISACARE HEALTHCARE SOLUTIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2011
Last Update Date: 06/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3497 COOLIDGE RD SUITE A
EAST LANSING MI
48823-6366
US

IV. Provider business mailing address

4234 CASCADE RD SE SUITE 3
GRAND RAPIDS MI
49546-8384
US

V. Phone/Fax

Practice location:
  • Phone: 517-336-0106
  • Fax: 517-336-0468
Mailing address:
  • Phone: 616-464-1117
  • Fax: 616-464-1044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. KRISTIAN SKOGEN
Title or Position: PRESIDENT
Credential:
Phone: 616-464-1117