MEDICARE: ADVANCED HEALTHCARE SERVICES, 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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1346407681
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED HEALTHCARE SERVICES, INC

Provider Business Mailing Address
First Line	:	7207 DESIARD ST
Second Line	:	STE 20
City	:	MONROE
State	:	LA
Zip	:	71203-3914
Country	:	US
Telephone Number	:	318-345-5966
Fax Number	:	318-345-5965

Provider Business Practice Location Address
First Line	:	7207 DESIARD ST
Second Line	:	STE 20
City	:	MONROE
State	:	LA
Zip	:	71203-3914
Country	:	US
Telephone Number	:	318-345-5966
Fax Number	:	318-345-5965

Authorized Official
Title or Position	:	OWNER
Name	:	LATHRESHA O'NEAL
Credential	:
Telephone Number	:	318-345-5966

Provider Enumeration Date	:	05/22/2008
Last Update Date	:	05/22/2008

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