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General NPI Number Information
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NPI Number | 1316607187
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Entity Type | Organization
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Legal Business Name | ADVANCE SAM CARE, INC.
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Dates
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Enumeration Date | 12/21/2021
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Last Update Date | 04/18/2023
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Provider Practice Location Address
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Address Line | 2101 VISTA PKWY STE 200
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City | WEST PALM BEACH
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State | FL
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Zip | 33411-2706
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Country | US
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Telephone | 561-228-7450
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Fax |
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Provider Business Mailing Address
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Address Line | 2101 VISTA PKWY STE 200
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City | WEST PALM BEACH
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State | FL
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Zip | 33411-2706
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Country | US
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Telephone | 561-228-7450
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TIBAB DELISSER
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Credential |
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Telephone | 786-234-9955
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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 |
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License Number State |
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