Provider Demographics
NPI:1831663236
Name:ADVANCED CARE SUPPORT CORPORATION
Entity Type:Organization
Organization Name:ADVANCED CARE SUPPORT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR. OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:
Authorized Official - Last Name:BRISKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-616-0100
Mailing Address - Street 1:252 W SWAMP RD STE 7
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2465
Mailing Address - Country:US
Mailing Address - Phone:267-616-0100
Mailing Address - Fax:267-224-4508
Practice Address - Street 1:252 W SWAMP RD STE 7
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2465
Practice Address - Country:US
Practice Address - Phone:267-616-0100
Practice Address - Fax:267-224-4508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1030081030001Medicaid