MEDICARE: ADVANCED HOME 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

General Provider Information

NPI Number	:	1942400411
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED HOME HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	1730 S COLLEGE AVE
Second Line	:	STE. 304
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-1073
Country	:	US
Telephone Number	:	970-493-8500
Fax Number	:	970-493-8508

Provider Business Practice Location Address
First Line	:	1730 S COLLEGE AVE
Second Line	:	STE. 304
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-1073
Country	:	US
Telephone Number	:	970-493-8500
Fax Number	:	970-493-8508

Authorized Official
Title or Position	:	OWNER ADMINISTRATOR
Name	:	MS. FARRELL DEE BROWN
Credential	:	LPN
Telephone Number	:	970-493-1899

Provider Enumeration Date	:	07/23/2007
Last Update Date	:	03/27/2012

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