Provider Demographics
NPI:1003007105
Name:ADVISACARE HEALTHCARE SOLUTIONS, INC.
Entity Type:Organization
Organization Name:ADVISACARE HEALTHCARE SOLUTIONS, INC.
Other - Org Name:ADVISACARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LISE'
Authorized Official - Middle Name:
Authorized Official - Last Name:SKOGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-464-1117
Mailing Address - Street 1:4234 CASCADE RD SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-8384
Mailing Address - Country:US
Mailing Address - Phone:616-464-1117
Mailing Address - Fax:616-464-1044
Practice Address - Street 1:3600 PORT OF TACOMA RD STE 511
Practice Address - Street 2:
Practice Address - City:FIFE
Practice Address - State:WA
Practice Address - Zip Code:98424-1044
Practice Address - Country:US
Practice Address - Phone:253-922-5501
Practice Address - Fax:253-922-5308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602586915251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health