Provider Demographics
NPI:1558926345
Name:ADVANCED CARE LIFE SERVICES, LLC
Entity Type:Organization
Organization Name:ADVANCED CARE LIFE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MACGREGOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-622-8168
Mailing Address - Street 1:1750 DELTA WATERS ROAD SUITE 102 BOX# 310
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-4132
Mailing Address - Country:US
Mailing Address - Phone:541-622-8168
Mailing Address - Fax:541-622-8266
Practice Address - Street 1:2821 BULLOCK RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-4132
Practice Address - Country:US
Practice Address - Phone:541-951-4302
Practice Address - Fax:541-622-8266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-07
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care