MEDICARE: ADVANTAGE HOME HEALTH LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	251E00000X	Home Health Agency
3	3747P1801X	Personal Care Attendant
4	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1518762327
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANTAGE HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	325 SQUIREBROOK DR
Second Line	:
City	:	DESOTO
State	:	TX
Zip	:	75115-2914
Country	:	US
Telephone Number	:	469-245-4990
Fax Number	:	469-533-4902

Provider Business Practice Location Address
First Line	:	111 EXECUTIVE WAY STE 102
Second Line	:
City	:	DESOTO
State	:	TX
Zip	:	75115-2388
Country	:	US
Telephone Number	:	214-377-9295
Fax Number	:	214-279-3601

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	TONYA C ROBERTS
Credential	:
Telephone Number	:	469-245-4990

Provider Enumeration Date	:	02/17/2025
Last Update Date	:	06/23/2026

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