Provider Demographics
NPI:1598503484
Name:ADVANTAGE OF LIFE HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:ADVANTAGE OF LIFE HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IRALIDYS
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-863-2273
Mailing Address - Street 1:1004 W LINEBAUGH AVE STE B
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-7837
Mailing Address - Country:US
Mailing Address - Phone:813-863-2273
Mailing Address - Fax:
Practice Address - Street 1:1004 W LINEBAUGH AVE STE B
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-7837
Practice Address - Country:US
Practice Address - Phone:813-863-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services