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General NPI Number Information
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NPI Number | 1235289547
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Entity Type | Organization
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Legal Business Name | ADVANTAGE COMMUNITY SERVICES
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1349 PRAIRIE DR
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City | LEWISVILLE
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State | TX
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Zip | 75067-5564
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Country | US
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Telephone | 972-571-5910
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Fax |
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Provider Business Mailing Address
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Address Line | 1349 PRAIRIE DRIVE
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City | LEWISVILLE
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State | TX
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Zip | 75067
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Country | US
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Telephone | 972-571-5910
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAVID ALAN ROGERS
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Credential | M.B.S.
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Telephone | 972-245-7949
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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