Provider Demographics
NPI:1336153162
Name:ADVANCED TECHNOLOGIES IN HOME CARE
Entity Type:Organization
Organization Name:ADVANCED TECHNOLOGIES IN HOME CARE
Other - Org Name:AT HOME CARE STAFFING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:P
Authorized Official - Last Name:MCGEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-358-0631
Mailing Address - Street 1:3228 W CARY ST STE A
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-3400
Mailing Address - Country:US
Mailing Address - Phone:804-358-0631
Mailing Address - Fax:804-497-2112
Practice Address - Street 1:3228 W CARY ST
Practice Address - Street 2:SUITE A
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23221-3400
Practice Address - Country:US
Practice Address - Phone:804-358-0631
Practice Address - Fax:804-497-2112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA008703841251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA008703841Medicaid