Provider Demographics
NPI:1962239293
Name:ADVANCE ASSISTED CARE
Entity type:Organization
Organization Name:ADVANCE ASSISTED CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHANTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:TSHIKAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-900-5080
Mailing Address - Street 1:10001 THOMAS BROOKE PL
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-7826
Mailing Address - Country:US
Mailing Address - Phone:301-900-5080
Mailing Address - Fax:301-649-3221
Practice Address - Street 1:10001 THOMAS BROOKE PL
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-7826
Practice Address - Country:US
Practice Address - Phone:301-900-5080
Practice Address - Fax:301-649-3221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health