MEDICARE: ADVOCATE HEALTHCARE 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	014774	TX

General Provider Information

NPI Number	:	1730457466
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVOCATE HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	1312 GRIGSBY AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-6873
Country	:	US
Telephone Number	:	214-449-1450
Fax Number	:	214-449-1416

Provider Business Practice Location Address
First Line	:	1312 GRIGSBY AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-6873
Country	:	US
Telephone Number	:	214-449-1450
Fax Number	:	214-449-1416

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NICOLE CHILDS
Credential	:
Telephone Number	:	214-497-0917

Provider Enumeration Date	:	12/08/2011
Last Update Date	:	09/13/2013

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