1437584554 NPI number — ADVANTAGE HOME CARE MANAGEMENT INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437584554 NPI number — ADVANTAGE HOME CARE MANAGEMENT INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANTAGE HOME CARE MANAGEMENT INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437584554
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/09/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17515 W 9 MILE RD
Provider Second Line Business Mailing Address:
STE 980
Provider Business Mailing Address City Name:
SOUTHFIELD
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48075-4403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-569-8400
Provider Business Mailing Address Fax Number:
248-569-5070

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17515 W 9 MILE RD
Provider Second Line Business Practice Location Address:
STE 980
Provider Business Practice Location Address City Name:
SOUTHFIELD
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48075-4403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-569-8400
Provider Business Practice Location Address Fax Number:
248-569-5070
Provider Enumeration Date:
09/09/2013

Additional Information

Authorized Official

Authorized Official Last Name:
HASTINGS
Authorized Official First Name:
KELSEY
Authorized Official Middle Name:
KATHLEEN
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
248-569-8400

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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