Provider Demographics
NPI:1316127806
Name:ADVANCING AT HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:ADVANCING AT HOME HEALTH CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BURT
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-657-8969
Mailing Address - Street 1:702 FAIR PARK DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HENDERSON
Mailing Address - State:TX
Mailing Address - Zip Code:75654
Mailing Address - Country:US
Mailing Address - Phone:903-657-6050
Mailing Address - Fax:903-657-4361
Practice Address - Street 1:702 FAIR PARK DR
Practice Address - Street 2:SUITE 101
Practice Address - City:HENDERSON
Practice Address - State:TX
Practice Address - Zip Code:75654
Practice Address - Country:US
Practice Address - Phone:903-657-6050
Practice Address - Fax:903-657-4361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX74-7038Medicare PIN