Provider Demographics
NPI:1194241927
Name:ADVANCED LIVING OPTIONS, INC.
Entity type:Organization
Organization Name:ADVANCED LIVING OPTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:S
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-551-9284
Mailing Address - Street 1:PO BOX 47700
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78265-8700
Mailing Address - Country:US
Mailing Address - Phone:210-551-9284
Mailing Address - Fax:210-590-9503
Practice Address - Street 1:12126 WILDROSE HILL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-2900
Practice Address - Country:US
Practice Address - Phone:210-551-9284
Practice Address - Fax:210-590-9503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency