Provider Demographics
NPI:1376092726
Name:ADVANTAGE CHOICE CARE, LLC
Entity Type:Organization
Organization Name:ADVANTAGE CHOICE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:REINALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:336-740-0899
Mailing Address - Street 1:497 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-3710
Mailing Address - Country:US
Mailing Address - Phone:201-471-7700
Mailing Address - Fax:
Practice Address - Street 1:1381 FULTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-2607
Practice Address - Country:US
Practice Address - Phone:336-740-0899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care