Provider Demographics
NPI:1649222746
Name:ADVANCED HOME HEALTH CARE INCORPORATED
Entity Type:Organization
Organization Name:ADVANCED HOME HEALTH CARE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAROCHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-342-7076
Mailing Address - Street 1:2834 45TH STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322
Mailing Address - Country:US
Mailing Address - Phone:219-922-6700
Mailing Address - Fax:219-924-3005
Practice Address - Street 1:2834 45TH STREET
Practice Address - Street 2:SUITE B
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322
Practice Address - Country:US
Practice Address - Phone:219-922-6700
Practice Address - Fax:219-924-3005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN157580Medicare Oscar/Certification