Provider Demographics
NPI:1942400411
Name:ADVANCED HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:ADVANCED HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FARRELL
Authorized Official - Middle Name:DEE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:970-493-1899
Mailing Address - Street 1:1730 S COLLEGE AVE
Mailing Address - Street 2:STE. 304
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-1073
Mailing Address - Country:US
Mailing Address - Phone:970-493-8500
Mailing Address - Fax:970-493-8508
Practice Address - Street 1:1730 S COLLEGE AVE
Practice Address - Street 2:STE. 304
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-1073
Practice Address - Country:US
Practice Address - Phone:970-493-8500
Practice Address - Fax:970-493-8508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO067478Medicare Oscar/Certification