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General NPI Number Information
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NPI Number | 1649440728
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Entity Type | Organization
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Legal Business Name | ADVANCED CARE AGENCY INC.
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 05/07/2010
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Provider Practice Location Address
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Address Line | 212 SHANGRI LA CIRCLE
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City | EDGEWATER
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State | FL
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Zip | 32132
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Country | US
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Telephone | 386-478-0399
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Fax | 386-427-6425
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Provider Business Mailing Address
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Address Line | 212 SHANGRI LA CIRCLE
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City | EDGEWATER
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State | FL
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Zip | 32132
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Country | US
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Telephone | 386-478-0399
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Fax | 386-427-6425
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS DIANE S SWINDLE
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Credential |
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Telephone | 386-478-0399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | CNA51755
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License Number State | FL
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