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General NPI Number Information
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NPI Number | 1093585655
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Entity Type | Organization
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Legal Business Name | ADVANTAGE SENIOR SOLUTIONS AND CONCIERGE
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Dates
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Enumeration Date | 01/04/2024
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Last Update Date | 01/04/2024
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Provider Practice Location Address
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Address Line | 3027 ARABIAN DR
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86404-2651
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Country | US
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Telephone | 909-557-4133
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Fax |
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Provider Business Mailing Address
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Address Line | 1642 MCCULLOCH BLVD N # 463
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-0961
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Country | US
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Telephone | 928-733-8681
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Fax |
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Authorized Official
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Title or Position | OWNER, PRESIDENT
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Name | RACHELLE RENEE DAVIDHIZAR
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Credential | MSW
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Telephone | 909-557-4133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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