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General NPI Number Information
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NPI Number | 1700852761
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Entity Type | Organization
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Legal Business Name | ADVANTAGE HOME ASSISTED CARE, INC.
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Dates
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Enumeration Date | 02/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 13465 WALSINGHAM RD
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City | LARGO
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State | FL
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Zip | 33774-3528
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Country | US
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Telephone | 727-593-0878
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Fax | 727-593-3240
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Provider Business Mailing Address
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Address Line | 13465 WALSINGHAM RD
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City | LARGO
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State | FL
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Zip | 33774-3528
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Country | US
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Telephone | 727-593-0878
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Fax | 727-593-3240
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JERRY ALLEN FINNIN
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Credential | L.P.N.
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Telephone | 727-593-0878
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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 | FL
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