MEDICARE: ADVOCATE HEALTHCARE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		TX

General Provider Information

NPI Number	:	1134417629
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVOCATE HEALTHCARE INC.

Provider Business Mailing Address
First Line	:	1312 GRIGSBY AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-6873
Country	:	US
Telephone Number	:	214-476-2360
Fax Number	:

Provider Business Practice Location Address
First Line	:	1312 GRIGSBY AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-6873
Country	:	US
Telephone Number	:	214-476-2360
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. KAREN BREITSCHOPF
Credential	:	R.N.
Telephone Number	:	512-698-2235

Provider Enumeration Date	:	07/18/2011
Last Update Date	:	07/18/2011

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