Provider Demographics
NPI:1750690608
Name:ADVANCED HOME CARE, INC.
Entity type:Organization
Organization Name:ADVANCED HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERROL
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-364-1064
Mailing Address - Street 1:3273 S TRUCKEE WAY
Mailing Address - Street 2:18-101
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-6120
Mailing Address - Country:US
Mailing Address - Phone:720-364-1064
Mailing Address - Fax:
Practice Address - Street 1:3273 S TRUCKEE WAY
Practice Address - Street 2:18-101
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-6120
Practice Address - Country:US
Practice Address - Phone:720-364-1064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO153631251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health