Provider Demographics
NPI:1356371066
Name:ADVANTAGE HOME HEALTH SERVICES INC
Entity type:Organization
Organization Name:ADVANTAGE HOME HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:FAST
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:434-455-4335
Mailing Address - Street 1:2007 TATE SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-1111
Mailing Address - Country:US
Mailing Address - Phone:434-455-4335
Mailing Address - Fax:434-455-2167
Practice Address - Street 1:2007 TATE SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-1111
Practice Address - Country:US
Practice Address - Phone:434-455-4335
Practice Address - Fax:434-455-2167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0021744581251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA497606Medicare ID - Type UnspecifiedPARTICIPATING PROVIDER NO