Provider Demographics
NPI:1083659775
Name:ADVANCED TECHNOLOGIES IN HOME CARE, INC
Entity Type:Organization
Organization Name:ADVANCED TECHNOLOGIES IN HOME CARE, INC
Other - Org Name:AT HOME CARE, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSLOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-576-0087
Mailing Address - Street 1:366 MCLAWS CIR STE 2
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-6354
Mailing Address - Country:US
Mailing Address - Phone:757-220-2112
Mailing Address - Fax:757-220-2745
Practice Address - Street 1:366 MCLAWS CIR
Practice Address - Street 2:SUITE 2
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-6352
Practice Address - Country:US
Practice Address - Phone:757-220-2112
Practice Address - Fax:757-220-2745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA497600251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA497600Medicare Oscar/Certification