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General NPI Number Information
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NPI Number | 1659468866
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Entity Type | Organization
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Legal Business Name | ADVANCE HOME CARE INC
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Dates
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Enumeration Date | 10/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1595 HARLAN ST
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City | LAKEWOOD
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State | CO
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Zip | 80214-1535
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Country | US
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Telephone | 720-331-0921
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Fax | 303-750-1087
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Provider Business Mailing Address
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Address Line | 1595 HARLAN ST
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City | LAKEWOOD
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State | CO
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Zip | 80214-1535
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Country | US
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Telephone | 720-331-0921
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Fax | 303-750-1087
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Authorized Official
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Title or Position | PRESIDENT
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Name | ZOHREH AZIZI
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Credential | RN
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Telephone | 720-331-0921
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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 | 20061402068
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License Number State | CO
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