Provider Demographics
NPI:1114320702
Name:ADVANCED HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:ADVANCED HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:OLAWALE
Authorized Official - Last Name:JUBRIL
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN
Authorized Official - Phone:269-459-1270
Mailing Address - Street 1:5320 HOLIDAY TERRACE
Mailing Address - Street 2:SUITE 7 E
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009
Mailing Address - Country:US
Mailing Address - Phone:269-459-1270
Mailing Address - Fax:269-459-8200
Practice Address - Street 1:5320 HOLIDAY TER
Practice Address - Street 2:SUITE 7 E
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-2100
Practice Address - Country:US
Practice Address - Phone:269-459-1270
Practice Address - Fax:269-459-8200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-26
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health