Provider Demographics
NPI:1669824728
Name:ADVANTAGE COMMUNITY HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:ADVANTAGE COMMUNITY HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:C
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-606-2069
Mailing Address - Street 1:2808 JUANITA AVE
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34946-1243
Mailing Address - Country:US
Mailing Address - Phone:404-606-2069
Mailing Address - Fax:
Practice Address - Street 1:1690 RENAISSANCE COMMONS BLVD APT 1509
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-7213
Practice Address - Country:US
Practice Address - Phone:404-606-2069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-12
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9331261251J00000X
251S00000X
FL261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251J00000XAgenciesNursing Care
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLNAOtherNA
NAOtherNA