Provider Demographics
NPI:1124619275
Name:ADVANCE HOMEHEALTH SERVICES LLC
Entity type:Organization
Organization Name:ADVANCE HOMEHEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:
Authorized Official - Last Name:ENOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-683-4897
Mailing Address - Street 1:2142 LORRAINE AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAWN
Mailing Address - State:MD
Mailing Address - Zip Code:21207-5908
Mailing Address - Country:US
Mailing Address - Phone:301-683-4897
Mailing Address - Fax:
Practice Address - Street 1:2142 LORRAINE AVE
Practice Address - Street 2:
Practice Address - City:WOODLAWN
Practice Address - State:MD
Practice Address - Zip Code:21207-5908
Practice Address - Country:US
Practice Address - Phone:301-683-4897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health