Provider Demographics
NPI:1427864388
Name:ADVANCED QUALITY HOMECARE LLC
Entity type:Organization
Organization Name:ADVANCED QUALITY HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:317-523-1340
Mailing Address - Street 1:19815 KENSWICK DR APT 13302
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-2470
Mailing Address - Country:US
Mailing Address - Phone:317-523-1340
Mailing Address - Fax:
Practice Address - Street 1:19815 KENSWICK DR APT 13302
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-2470
Practice Address - Country:US
Practice Address - Phone:317-523-1340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care