Provider Demographics
NPI:1194015701
Name:ADVANCED HEALTHCARE SYSTEMS LLC
Entity Type:Organization
Organization Name:ADVANCED HEALTHCARE SYSTEMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QUALITY ASSURANCE/IMPROVEMENT
Authorized Official - Prefix:
Authorized Official - First Name:ERICOKA
Authorized Official - Middle Name:N
Authorized Official - Last Name:THIBODEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:BS, JD
Authorized Official - Phone:337-254-8153
Mailing Address - Street 1:701 W ALEXANDER ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70501-1217
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:701 W ALEXANDER ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-1217
Practice Address - Country:US
Practice Address - Phone:337-254-8153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-15
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care