Provider Demographics
NPI:1629431424
Name:ADVANCE HELP HOME CARE
Entity Type:Organization
Organization Name:ADVANCE HELP HOME CARE
Other - Org Name:ASSIST THE LIVING RESIDENT CARE HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DWIGHT
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BIRCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-717-8940
Mailing Address - Street 1:19811 LINDENFIELD PL
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-6696
Mailing Address - Country:US
Mailing Address - Phone:281-717-8940
Mailing Address - Fax:
Practice Address - Street 1:19811 LINDENFIELD PL
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-6696
Practice Address - Country:US
Practice Address - Phone:281-717-8045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCE HELP HOME CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-30
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3664534Medicaid