MEDICARE: ADVANCE HOME HEALTH CARE LLC

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

General Provider Information

NPI Number	:	1659751006
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCE HOME HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	1837 S MESA DR
Second Line	:	SUITE C202
City	:	MESA
State	:	AZ
Zip	:	85210-6246
Country	:	US
Telephone Number	:	480-264-7866
Fax Number	:	480-686-8263

Provider Business Practice Location Address
First Line	:	1837 S MESA DR
Second Line	:	SUITE C202
City	:	MESA
State	:	AZ
Zip	:	85210-6246
Country	:	US
Telephone Number	:	480-264-7866
Fax Number	:	480-686-8263

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	YANELIS N GONZALEZ
Credential	:
Telephone Number	:	480-264-7866

Provider Enumeration Date	:	06/01/2015
Last Update Date	:	02/16/2022

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Directions to “ADVANCE HOME HEALTH CARE LLC ” Practice Location

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