Provider Demographics
NPI:1346395530
Name:ADVANTAGE CARE IN HOME SERVICES, INC
Entity Type:Organization
Organization Name:ADVANTAGE CARE IN HOME SERVICES, INC
Other - Org Name:ADVANTAGE CARE COMMUNITY SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:D
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-430-7878
Mailing Address - Street 1:PO BOX 1258
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-1258
Mailing Address - Country:US
Mailing Address - Phone:252-430-7878
Mailing Address - Fax:252-430-0000
Practice Address - Street 1:103 WORTTHAM COURT
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536
Practice Address - Country:US
Practice Address - Phone:252-430-7878
Practice Address - Fax:252-430-0000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL091069251C00000X, 251S00000X, 320900000X
NCHC3114251J00000X
NCHC2292251J00000X
NCHC2505251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC66001414Medicaid
NC3409497Medicaid
NC66001412Medicaid
NC6600904Medicaid
NC8301504Medicaid