Provider Demographics
NPI:1770819757
Name:ADVANTAGE HEALTH, INC
Entity Type:Organization
Organization Name:ADVANTAGE HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LEA
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:JERPSETH
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:928-317-1300
Mailing Address - Street 1:2281 W 24TH ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6154
Mailing Address - Country:US
Mailing Address - Phone:928-317-1300
Mailing Address - Fax:928-317-1315
Practice Address - Street 1:2281 W 24TH ST
Practice Address - Street 2:SUITE 7
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6154
Practice Address - Country:US
Practice Address - Phone:928-317-1300
Practice Address - Fax:928-317-1315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-26
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ037280Medicare Oscar/Certification