Provider Demographics
NPI:1548430671
Name:ADVANCE HOME CARE, INC.
Entity Type:Organization
Organization Name:ADVANCE HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BAGRAT
Authorized Official - Middle Name:
Authorized Official - Last Name:VAHRAMYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-848-2100
Mailing Address - Street 1:1903 N GLENOAKS BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-3826
Mailing Address - Country:US
Mailing Address - Phone:818-848-2100
Mailing Address - Fax:
Practice Address - Street 1:1903 N GLENOAKS BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-3826
Practice Address - Country:US
Practice Address - Phone:818-848-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2917042OtherCA CORPORATE NUMBER