Provider Demographics
NPI:1558792408
Name:ADVANTAGE HEALTH NETWORK
Entity Type:Organization
Organization Name:ADVANTAGE HEALTH NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:SPARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-378-9415
Mailing Address - Street 1:2300 W MEADOWVIEW RD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-3720
Mailing Address - Country:US
Mailing Address - Phone:336-378-9415
Mailing Address - Fax:336-378-9417
Practice Address - Street 1:2300 W MEADOWVIEW RD
Practice Address - Street 2:SUIRW 117
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-3720
Practice Address - Country:US
Practice Address - Phone:336-378-9415
Practice Address - Fax:336-378-9417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC=========OtherPRIVATE