Provider Demographics
NPI:1093488496
Name:ADVANTAGE TRANSITION AGENCY, LLC.
Entity Type:Organization
Organization Name:ADVANTAGE TRANSITION AGENCY, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KEMAH
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLLEH
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:267-444-2011
Mailing Address - Street 1:11059 E BETHANY DR STE 104
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-2617
Mailing Address - Country:US
Mailing Address - Phone:267-444-2011
Mailing Address - Fax:720-367-5755
Practice Address - Street 1:11059 E BETHANY DR STE 104
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2617
Practice Address - Country:US
Practice Address - Phone:267-444-2011
Practice Address - Fax:720-367-5755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management