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NPI 1477007904

NPI 1477007904 : ADVANCEMENT CARE LLC : HOUSTON, TX

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General NPI Number Information
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    NPI Number           |    1477007904
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    Entity Type          |    Organization 
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    Legal Business Name  |    ADVANCEMENT CARE LLC 
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Dates
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    Enumeration Date     |    08/13/2016
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    Last Update Date     |    08/13/2016
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Provider Practice Location Address
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    Address Line         |    11222 BRAESRIDGE DR APT 3442
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77071-2109
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    Country              |    US
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    Telephone            |    832-335-5909
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    11222 BRAESRIDGE DR APT 3442
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77071-2109
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    Country              |    US
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    Telephone            |    832-335-5909
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     TIFFANY  BRYANT 
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    Credential           |    
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    Telephone            |    832-335-5909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251B00000X
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    Taxonomy Name        |    Case Management Agency
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    385HR2060X
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    Taxonomy Name        |    Child Intellectual and/or Developmental Disabilities Respite Care
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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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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