Provider Demographics
NPI:1659668853
Name:ADVANCED PRO HOME CARE, INC.
Entity Type:Organization
Organization Name:ADVANCED PRO HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:DALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-451-0707
Mailing Address - Street 1:317 BRICK BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-6031
Mailing Address - Country:US
Mailing Address - Phone:732-451-0707
Mailing Address - Fax:732-451-0040
Practice Address - Street 1:317 BRICK BLVD STE 100
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-6031
Practice Address - Country:US
Practice Address - Phone:732-451-0707
Practice Address - Fax:732-451-0040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0263362Medicaid