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General NPI Number Information
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NPI Number | 1528333929
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Entity Type | Organization
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Legal Business Name | ADVANTAGE SENIOR CARE, LLC
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Dates
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Enumeration Date | 03/19/2012
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Last Update Date | 08/28/2015
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Provider Practice Location Address
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Address Line | 4142 MCKNIGHT RD
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City | TEXARKANA
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State | TX
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Zip | 75503
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Country | US
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Telephone | 903-280-7072
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Fax | 903-255-7723
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Provider Business Mailing Address
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Address Line | 4142 MCKNIGHT RD.
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City | TEXARKANA
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State | TX
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Zip | 75503
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Country | US
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Telephone | 903-280-7072
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Fax | 903-255-7723
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Authorized Official
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Title or Position | ADMINISTRATOR/OWNER
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Name | CATHERIN FAYE CAMPBELL
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Credential |
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Telephone | 903-280-7072
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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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