Provider Demographics
NPI:1225643000
Name:ADVANCED HEALTHCARE AND ALLIED SERVICES, LLC
Entity Type:Organization
Organization Name:ADVANCED HEALTHCARE AND ALLIED SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GIDEON
Authorized Official - Middle Name:
Authorized Official - Last Name:OBI
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:301-765-4576
Mailing Address - Street 1:6305 IVY LN STE 101
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-6326
Mailing Address - Country:US
Mailing Address - Phone:301-765-4576
Mailing Address - Fax:
Practice Address - Street 1:6305 IVY LN STE 101
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-6326
Practice Address - Country:US
Practice Address - Phone:301-765-4576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health