Provider Demographics
NPI:1801029327
Name:ADVANCED HOME & COMMUNITY CARE OF LAREDO, INC.
Entity Type:Organization
Organization Name:ADVANCED HOME & COMMUNITY CARE OF LAREDO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DIBART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-235-7465
Mailing Address - Street 1:4101 MERIDA DRIVE
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78046-8754
Mailing Address - Country:US
Mailing Address - Phone:956-235-7465
Mailing Address - Fax:
Practice Address - Street 1:4101 MERIDA DRIVE
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78046-8754
Practice Address - Country:US
Practice Address - Phone:956-235-7465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health