Provider Demographics
NPI:1154622819
Name:ADVANCED NURSING CARE
Entity type:Organization
Organization Name:ADVANCED NURSING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUNGU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-957-3223
Mailing Address - Street 1:1049 LAKEVIEW AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-4747
Mailing Address - Country:US
Mailing Address - Phone:978-957-3223
Mailing Address - Fax:978-957-4111
Practice Address - Street 1:1049 LAKEVIEW AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-4747
Practice Address - Country:US
Practice Address - Phone:978-957-3223
Practice Address - Fax:978-957-4111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-11
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAR2499251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health