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General NPI Number Information
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NPI Number | 1760638399
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Entity Type | Organization
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Legal Business Name | ADVANTAGE HEALTH CARE
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Dates
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Enumeration Date | 08/14/2008
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 155 S EXECUTIVE DR STE 102
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City | BROOKFIELD
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State | WI
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Zip | 53005-4205
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Country | US
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Telephone | 262-432-4663
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Fax | 262-432-0226
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Provider Business Mailing Address
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Address Line | 155 S EXECUTIVE DR STE 102
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City | BROOKFIELD
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State | WI
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Zip | 53005-4205
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Country | US
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Telephone | 262-432-4663
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Fax | 262-432-0226
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. WENDY JOANN KEEHAN
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Credential | RN
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Telephone | 262-432-4663
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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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