Provider Demographics
NPI:1760638399
Name:ADVANTAGE HEALTH CARE
Entity Type:Organization
Organization Name:ADVANTAGE HEALTH CARE
Other - Org Name:ADVANTAGE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:JOANN
Authorized Official - Last Name:KEEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:262-432-4663
Mailing Address - Street 1:155 S EXECUTIVE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-4205
Mailing Address - Country:US
Mailing Address - Phone:262-432-4663
Mailing Address - Fax:262-432-0226
Practice Address - Street 1:155 S EXECUTIVE DR STE 102
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-4205
Practice Address - Country:US
Practice Address - Phone:262-432-4663
Practice Address - Fax:262-432-0226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health