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General NPI Number Information
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NPI Number | 1861212185
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Entity Type | Organization
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Legal Business Name | ADVANCED SPECIALIZED KARE LLC
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Dates
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Enumeration Date | 10/11/2024
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 200 MAIN ST STE 1
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City | COLLINS
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State | MS
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Zip | 39428-6188
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Country | US
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Telephone | 601-543-8974
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Fax |
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Provider Business Mailing Address
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Address Line | 200 MAIN ST STE 1
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City | COLLINS
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State | MS
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Zip | 39428-6188
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Country | US
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Telephone | 601-543-8974
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Fax |
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Authorized Official
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Title or Position | RN
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Name | SHATEARANY GREEN
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Credential |
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Telephone | 601-543-8974
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | NULL
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Taxonomy #2
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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 | NULL
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Taxonomy #3
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State | NULL
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Taxonomy #4
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State | NULL
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Taxonomy #5
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State | NULL
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Taxonomy #6
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State | NULL
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Taxonomy #7
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State | NULL
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Taxonomy #8
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State | NULL
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Taxonomy #9
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | NULL
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