Provider Demographics
NPI:1700080355
Name:ADVANTAGE HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:ADVANTAGE HOME HEALTH CARE, INC.
Other - Org Name:ADVANTAGE HOME HEALTH CARE INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:WHETSEL
Authorized Official - Suffix:
Authorized Official - Credentials:RN CEHCH
Authorized Official - Phone:740-775-1114
Mailing Address - Street 1:4292 OLD SCIOTO TRL
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-6641
Mailing Address - Country:US
Mailing Address - Phone:740-354-5671
Mailing Address - Fax:740-354-4432
Practice Address - Street 1:4292 OLD SCIOTO TRL
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-6641
Practice Address - Country:US
Practice Address - Phone:740-354-5671
Practice Address - Fax:740-354-4432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH522896919251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH412231OtherPASSPORT PROVIDER