Provider Demographics
NPI: | 1528304318 |
---|---|
Name: | ADVANTAGE HEALTH AND SOCIAL SERVICES LLC |
Entity type: | Organization |
Organization Name: | ADVANTAGE HEALTH AND SOCIAL SERVICES LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | MEMBER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SHIGGY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ROSENBERG |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 973-678-5500 |
Mailing Address - Street 1: | 576 CENTRAL AVE |
Mailing Address - Street 2: | SUITE 301 |
Mailing Address - City: | EAST ORANGE |
Mailing Address - State: | NJ |
Mailing Address - Zip Code: | 07018-1951 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 973-678-5500 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 576 CENTRAL AVE |
Practice Address - Street 2: | SUITE 301 |
Practice Address - City: | EAST ORANGE |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 07018-1951 |
Practice Address - Country: | US |
Practice Address - Phone: | 973-678-5500 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-12-24 |
Last Update Date: | 2020-11-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251E00000X | Agencies | Home Health | |
No | 251B00000X | Agencies | Case Management | |
No | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | |
No | 251G00000X | Agencies | Hospice Care, Community Based | |
No | 251J00000X | Agencies | Nursing Care | |
No | 251S00000X | Agencies | Community/Behavioral Health | |
No | 251X00000X | Agencies | Supports Brokerage | |
No | 253Z00000X | Agencies | In Home Supportive Care | |
No | 302F00000X | Managed Care Organizations | Exclusive Provider Organization | |
No | 320600000X | Residential Treatment Facilities | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
No | 320700000X | Residential Treatment Facilities | Residential Treatment Facility, Physical Disabilities | |
No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
No | 385H00000X | Respite Care Facility | Respite Care | |
No | 385HR2060X | Respite Care Facility | Respite Care | Respite Care, Intellectual and/or Developmental Disabilities, Child |
No | 385HR2065X | Respite Care Facility | Respite Care | Respite Care, Physical Disabilities, Child |