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General NPI Number Information
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NPI Number | 1639264104
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Entity Type | Organization
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Legal Business Name | ADVANTAGE HOME HEALTH CARE, LLC
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 14872 N 142ND LANE
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City | SURPRISE
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State | AZ
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Zip | 85379-8726
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Country | US
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Telephone | 623-792-5647
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Fax | 623-215-6674
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Provider Business Mailing Address
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Address Line | 14872 N 142ND LANE
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City | SURPRISE
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State | AZ
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Zip | 85379-8726
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Country | US
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Telephone | 623-792-5647
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Fax | 623-215-6674
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MRS. STEPHANIE SCOTT
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Credential | RN
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Telephone | 623-792-5647
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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 | L13068095
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License Number State | AZ
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