Provider Demographics
NPI:1821387234
Name:ADVANCED HEALTH RESOURCES
Entity Type:Organization
Organization Name:ADVANCED HEALTH RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-465-3277
Mailing Address - Street 1:1224 COPELAND OAKS DR
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-6614
Mailing Address - Country:US
Mailing Address - Phone:919-465-3277
Mailing Address - Fax:919-465-3222
Practice Address - Street 1:1021 S FAYETTEVILLE ST
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-6809
Practice Address - Country:US
Practice Address - Phone:336-625-9100
Practice Address - Fax:336-625-2800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-06
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8702436Medicaid