Provider Demographics
NPI:1295905412
Name:ADVANCED HOMECARE, INC.
Entity type:Organization
Organization Name:ADVANCED HOMECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:REID
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-343-9200
Mailing Address - Street 1:6816 SOUTHPOINT PKWY
Mailing Address - Street 2:UNIT 600
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-1700
Mailing Address - Country:US
Mailing Address - Phone:904-470-5000
Mailing Address - Fax:
Practice Address - Street 1:6816 SOUTHPOINT PKWY
Practice Address - Street 2:UNIT 600
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-1700
Practice Address - Country:US
Practice Address - Phone:904-470-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health