Provider Demographics
NPI:1316655608
Name:AADVANCE HOME HEALTH SERVICES
Entity type:Organization
Organization Name:AADVANCE HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AIDE
Authorized Official - Prefix:
Authorized Official - First Name:IJA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-639-3348
Mailing Address - Street 1:19357 PARADISE MANOR DR
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-5312
Mailing Address - Country:US
Mailing Address - Phone:301-639-3348
Mailing Address - Fax:
Practice Address - Street 1:517 N. ROLLING RD.
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228
Practice Address - Country:US
Practice Address - Phone:410-744-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD141516Medicaid