Provider Demographics
NPI:1255626669
Name:JOSEY ADVANTAGE, INC.
Entity type:Organization
Organization Name:JOSEY ADVANTAGE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-216-9044
Mailing Address - Street 1:4897 OLDE FOREST DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-8422
Mailing Address - Country:US
Mailing Address - Phone:269-216-9044
Mailing Address - Fax:269-353-1219
Practice Address - Street 1:810 W KILGORE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-3601
Practice Address - Country:US
Practice Address - Phone:269-216-9044
Practice Address - Fax:269-353-1219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-14
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health