Provider Demographics
NPI:1528578986
Name:ADVANTAGE CARE, LLC
Entity Type:Organization
Organization Name:ADVANTAGE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PHILANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-363-1141
Mailing Address - Street 1:305 CORSICANA ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89138-1596
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:305 CORSICANA ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89138-1596
Practice Address - Country:US
Practice Address - Phone:770-363-1141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health