Provider Demographics
NPI:1497909675
Name:ADVANCE HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:ADVANCE HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSSY
Authorized Official - Middle Name:NGOZI
Authorized Official - Last Name:NWACHUKWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-461-7563
Mailing Address - Street 1:9916 CHESSINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2986
Mailing Address - Country:US
Mailing Address - Phone:301-461-7563
Mailing Address - Fax:
Practice Address - Street 1:9916 CHESSINGTON WAY
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-2986
Practice Address - Country:US
Practice Address - Phone:301-461-7563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-13
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2587251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health