Provider Demographics
NPI:1164191508
Name:ADVANTAGE, LLC
Entity Type:Organization
Organization Name:ADVANTAGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINSLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:NYACK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:301-580-2618
Mailing Address - Street 1:12508 EASTBOURNE DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2039
Mailing Address - Country:US
Mailing Address - Phone:301-622-1688
Mailing Address - Fax:
Practice Address - Street 1:12508 EASTBOURNE DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2039
Practice Address - Country:US
Practice Address - Phone:301-622-1688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility