Provider Demographics
NPI:1396052205
Name:ADVANTAGE COMMUNITY RESOURCES LLC
Entity type:Organization
Organization Name:ADVANTAGE COMMUNITY RESOURCES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:MHR, BHCM, LADC US
Authorized Official - Phone:405-206-0177
Mailing Address - Street 1:11032 QUAIL CREEK RD STE 175
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-6217
Mailing Address - Country:US
Mailing Address - Phone:405-206-0177
Mailing Address - Fax:
Practice Address - Street 1:11032 QUAIL CREEK RD STE 175
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-6217
Practice Address - Country:US
Practice Address - Phone:405-206-0177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-13
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management