Provider Demographics
NPI:1508123068
Name:ADVANCED HOME HEALTH CARE
Entity Type:Organization
Organization Name:ADVANCED HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:GALVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-753-6270
Mailing Address - Street 1:550 S. ROOSEVELT
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52601
Mailing Address - Country:US
Mailing Address - Phone:319-753-6270
Mailing Address - Fax:319-753-6237
Practice Address - Street 1:550 S. ROOSEVELT
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601
Practice Address - Country:US
Practice Address - Phone:319-753-6270
Practice Address - Fax:319-753-6237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-20
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAIOWA DOESNT REQUIRE251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0404440Medicaid
IA0170373Medicaid