Provider Demographics
NPI:1952678088
Name:ADVANTAGECARE REHABILITATION, INC
Entity Type:Organization
Organization Name:ADVANTAGECARE REHABILITATION, INC
Other - Org Name:ADVANTAGECARE REHAB
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:HANCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-440-0145
Mailing Address - Street 1:5035 CLAIRTON BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-2103
Mailing Address - Country:US
Mailing Address - Phone:412-440-0145
Mailing Address - Fax:412-440-0143
Practice Address - Street 1:5035 CLAIRTON BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-2103
Practice Address - Country:US
Practice Address - Phone:412-440-0145
Practice Address - Fax:412-440-0143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy