Provider Demographics
NPI:1225364482
Name:ADVANTAGE HEALTHCARE, INC.
Entity Type:Organization
Organization Name:ADVANTAGE HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:EBALU
Authorized Official - Last Name:OGHARIBHOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-477-2428
Mailing Address - Street 1:1036 80TH CT N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55444-2049
Mailing Address - Country:US
Mailing Address - Phone:763-477-2428
Mailing Address - Fax:
Practice Address - Street 1:1036 80TH CT N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55444-2049
Practice Address - Country:US
Practice Address - Phone:763-477-2428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health