Provider Demographics
NPI:1710240239
Name:ADVANTAGE SENIOR DAYCARE
Entity Type:Organization
Organization Name:ADVANTAGE SENIOR DAYCARE
Other - Org Name:LT INTERNATIONAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-395-8808
Mailing Address - Street 1:6853 65TH ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95828-1200
Mailing Address - Country:US
Mailing Address - Phone:916-395-8808
Mailing Address - Fax:916-395-8803
Practice Address - Street 1:6853 65TH ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95828-1200
Practice Address - Country:US
Practice Address - Phone:916-395-8808
Practice Address - Fax:916-395-8803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care