Provider Demographics
NPI:1235493289
Name:ADVISACARE HEALTHCARE SOLUTIONS, INC
Entity Type:Organization
Organization Name:ADVISACARE HEALTHCARE SOLUTIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:LISE'
Authorized Official - Middle Name:
Authorized Official - Last Name:SKOGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-464-1117
Mailing Address - Street 1:8024 N 24TH AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-4828
Mailing Address - Country:US
Mailing Address - Phone:602-242-3800
Mailing Address - Fax:
Practice Address - Street 1:8024 N 24TH AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-4828
Practice Address - Country:US
Practice Address - Phone:602-242-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health