Provider Demographics
NPI:1649635780
Name:ADVANCED HOME HEALTHCARE GROUP OF OSCELA LLC
Entity type:Organization
Organization Name:ADVANCED HOME HEALTHCARE GROUP OF OSCELA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KHALID
Authorized Official - Middle Name:T
Authorized Official - Last Name:SAKR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-439-5363
Mailing Address - Street 1:241 RUBY AVE
Mailing Address - Street 2:SUITE 203A
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-5627
Mailing Address - Country:US
Mailing Address - Phone:727-439-5363
Mailing Address - Fax:
Practice Address - Street 1:241 RUBY AVE
Practice Address - Street 2:SUITE 203A
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-5627
Practice Address - Country:US
Practice Address - Phone:727-439-5363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health