Provider Demographics
NPI:1780622340
Name:ADVANCE HOME HEALTH CARE SERVICES, INC.
Entity type:Organization
Organization Name:ADVANCE HOME HEALTH CARE SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ABU
Authorized Official - Middle Name:HIBBON NOOR
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-945-1255
Mailing Address - Street 1:5237 OAKMAN BLVD.
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-4045
Mailing Address - Country:US
Mailing Address - Phone:313-945-1255
Mailing Address - Fax:313-945-1256
Practice Address - Street 1:5237 OAKMAN BLVD.
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-4045
Practice Address - Country:US
Practice Address - Phone:313-945-1255
Practice Address - Fax:313-945-1256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIN/A251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237690Medicare Oscar/Certification