Provider Demographics
NPI:1568115103
Name:CARE ADVANTAGE HOME CARE LLC
Entity Type:Organization
Organization Name:CARE ADVANTAGE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOONTZ
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:937-371-8177
Mailing Address - Street 1:3206 RIVER DOWNS CT
Mailing Address - Street 2:
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-3796
Mailing Address - Country:US
Mailing Address - Phone:937-371-8177
Mailing Address - Fax:
Practice Address - Street 1:4031 COLONEL GLENN HWY STE 450
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45431-2700
Practice Address - Country:US
Practice Address - Phone:937-637-3776
Practice Address - Fax:888-516-7031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care