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General NPI Number Information
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NPI Number | 1154622819
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Entity Type | Organization
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Legal Business Name | ADVANCED NURSING CARE
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Dates
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Enumeration Date | 11/11/2010
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Last Update Date | 11/11/2010
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Provider Practice Location Address
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Address Line | 1049 LAKEVIEW AVE SUITE 3
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City | DRACUT
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State | MA
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Zip | 01826-4747
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Country | US
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Telephone | 978-957-3223
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Fax | 978-957-4111
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Provider Business Mailing Address
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Address Line | 1049 LAKEVIEW AVE SUITE 3
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City | DRACUT
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State | MA
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Zip | 01826-4747
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Country | US
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Telephone | 978-957-3223
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Fax | 978-957-4111
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JOHN KUNGU
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Credential |
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Telephone | 978-957-3223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | R2499
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License Number State | MA
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