Provider Demographics
NPI:1497179527
Name:ADVANCED LIFE CARE PLANNING LLC
Entity Type:Organization
Organization Name:ADVANCED LIFE CARE PLANNING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ARLETTE
Authorized Official - Middle Name:C
Authorized Official - Last Name:LOESER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:212-947-8222
Mailing Address - Street 1:BOX 20377
Mailing Address - Street 2:PARK WEST STATION
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-1513
Mailing Address - Country:US
Mailing Address - Phone:917-543-2245
Mailing Address - Fax:775-320-7171
Practice Address - Street 1:255 KATAN AVE.
Practice Address - Street 2:SCORE REHAB
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10308
Practice Address - Country:US
Practice Address - Phone:646-688-5200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY556613251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health