Provider Demographics
NPI:1558085464
Name:ADVANCAL HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:ADVANCAL HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-994-8846
Mailing Address - Street 1:2514 VERANDA WAY
Mailing Address - Street 2:
Mailing Address - City:VENUS
Mailing Address - State:TX
Mailing Address - Zip Code:76084-3384
Mailing Address - Country:US
Mailing Address - Phone:214-994-8846
Mailing Address - Fax:
Practice Address - Street 1:2514 VERANDA WAY
Practice Address - Street 2:
Practice Address - City:VENUS
Practice Address - State:TX
Practice Address - Zip Code:76084-3384
Practice Address - Country:US
Practice Address - Phone:214-994-8846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-04
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health