Provider Demographics
NPI:1528440351
Name:ADVANCE SPECIALTY CARE NORTH, INC.
Entity type:Organization
Organization Name:ADVANCE SPECIALTY CARE NORTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMACHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-321-0938
Mailing Address - Street 1:6260 LAUREL CANYON BLVD STE 304
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3234
Mailing Address - Country:US
Mailing Address - Phone:818-308-3841
Mailing Address - Fax:818-308-3846
Practice Address - Street 1:6260 LAUREL CANYON BLVD STE 304
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3234
Practice Address - Country:US
Practice Address - Phone:818-308-3841
Practice Address - Fax:818-308-3846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-29
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health