Provider Demographics
NPI:1336488261
Name:ADVANCED SERVICES
Entity Type:Organization
Organization Name:ADVANCED SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:
Authorized Official - Last Name:PYROR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-461-0438
Mailing Address - Street 1:210 HOLLY ST
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-5104
Mailing Address - Country:US
Mailing Address - Phone:208-461-0438
Mailing Address - Fax:208-461-0446
Practice Address - Street 1:210 HOLLY ST
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-5104
Practice Address - Country:US
Practice Address - Phone:208-461-0438
Practice Address - Fax:208-461-0446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-13
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management