Provider Demographics
NPI:1902414022
Name:ADVENT HOME CARE AGENCY
Entity Type:Organization
Organization Name:ADVENT HOME CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADULT NURSE PRACTITIONER, DPS
Authorized Official - Prefix:MRS
Authorized Official - First Name:GINETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:THEODORE
Authorized Official - Suffix:
Authorized Official - Credentials:ANP-BC, DPS
Authorized Official - Phone:516-567-4167
Mailing Address - Street 1:249 POST AVE
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-2263
Mailing Address - Country:US
Mailing Address - Phone:516-307-8065
Mailing Address - Fax:
Practice Address - Street 1:249 POST AVE
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-2263
Practice Address - Country:US
Practice Address - Phone:516-307-8065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health