MEDICARE: ADVANTAGE HOSPICE, 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	251G00000X	Community Based Hospice Care Agency	011421	TX

General Provider Information

NPI Number	:	1770645269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANTAGE HOSPICE, INC.

Provider Business Mailing Address
First Line	:	6688 N CENTRAL EXPY
Second Line	:	SUITE 1300
City	:	DALLAS
State	:	TX
Zip	:	75206-3914
Country	:	US
Telephone Number	:	214-239-6500
Fax Number	:	214-239-6581

Provider Business Practice Location Address
First Line	:	6421 CAMP BOWIE BLVD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76116-5401
Country	:	US
Telephone Number	:	817-737-4300
Fax Number	:	817-737-4305

Authorized Official
Title or Position	:	CEO
Name	:	APRIL K ANTHONY
Credential	:
Telephone Number	:	214-239-6500

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	07/17/2007

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