Provider Demographics
NPI:1205530052
Name:ADVANCE PERSONAL CARE LLC
Entity type:Organization
Organization Name:ADVANCE PERSONAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HUY
Authorized Official - Middle Name:
Authorized Official - Last Name:DOAN
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:770-309-9689
Mailing Address - Street 1:4272 GRAVITT PL
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-4384
Mailing Address - Country:US
Mailing Address - Phone:770-309-9689
Mailing Address - Fax:
Practice Address - Street 1:4272 GRAVITT PL
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-4384
Practice Address - Country:US
Practice Address - Phone:770-309-9689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care