Healthcare Provider Details

I. General information

NPI: 1457974131
Provider Name (Legal Business Name): CARE ADVANTAGE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2020
Last Update Date: 02/21/2023
Certification Date: 02/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 PIDGEON HILL DR STE 208
STERLING VA
20165-6134
US

IV. Provider business mailing address

10041 MIDLOTHIAN TPKE
NORTH CHESTERFIELD VA
23235-4815
US

V. Phone/Fax

Practice location:
  • Phone: 703-539-6029
  • Fax: 888-908-4269
Mailing address:
  • Phone: 804-323-9464
  • Fax: 804-330-0156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC2100X
TaxonomyContinence Care Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY ROYSTER
Title or Position: SENIOR MANAGER OF ACCOUNTING
Credential:
Phone: 804-323-9464