Provider Demographics
NPI:1912225285
Name:HOMECARE ADVANTAGE
Entity type:Organization
Organization Name:HOMECARE ADVANTAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:PHILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-520-9353
Mailing Address - Street 1:103 S MCLEWEAN ST
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-4921
Mailing Address - Country:US
Mailing Address - Phone:252-520-9353
Mailing Address - Fax:252-526-0131
Practice Address - Street 1:103 S MCLEWEAN ST
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-4921
Practice Address - Country:US
Practice Address - Phone:252-520-9353
Practice Address - Fax:252-526-0131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC1773251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health