Provider Demographics
NPI:1982031456
Name:TRAVELER ADVOCATE, LLC
Entity Type:Organization
Organization Name:TRAVELER ADVOCATE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-717-2893
Mailing Address - Street 1:7557 N DREAMY DRAW DR
Mailing Address - Street 2:UNIT 252
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-4651
Mailing Address - Country:US
Mailing Address - Phone:602-717-2893
Mailing Address - Fax:
Practice Address - Street 1:7557 N DREAMY DRAW DR
Practice Address - Street 2:UNIT 252
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-4651
Practice Address - Country:US
Practice Address - Phone:602-717-2893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-30
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6499251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health