Provider Demographics
NPI:1679919195
Name:ADVENT CARE SYSTEMS
Entity Type:Organization
Organization Name:ADVENT CARE SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/COO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:BACON
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-876-3200
Mailing Address - Street 1:745 SOUTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313
Mailing Address - Country:US
Mailing Address - Phone:912-876-3200
Mailing Address - Fax:912-876-3236
Practice Address - Street 1:745 SOUTH MAIN
Practice Address - Street 2:745
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313
Practice Address - Country:US
Practice Address - Phone:912-876-3200
Practice Address - Fax:912-876-3236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 251E00000X, 261Q00000X, 261QC1500X, 302R00000X, 305S00000X, 311ZA0620X, 3245S0500X, 347C00000X, 347E00000X, 385H00000X
GA251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No305S00000XManaged Care OrganizationsPoint of Service
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
No347C00000XTransportation ServicesPrivate Vehicle
No347E00000XTransportation ServicesTransportation Broker
No385H00000XRespite Care FacilityRespite Care