Provider Demographics
NPI:1811358393
Name:ADVANCED HOME CARE, INC
Entity type:Organization
Organization Name:ADVANCED HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAI
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-489-9246
Mailing Address - Street 1:1088 RICE ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55117-2906
Mailing Address - Country:US
Mailing Address - Phone:651-489-9246
Mailing Address - Fax:651-488-7364
Practice Address - Street 1:1088 RICE ST
Practice Address - Street 2:SUITE B
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55117-2906
Practice Address - Country:US
Practice Address - Phone:651-489-9246
Practice Address - Fax:651-488-7364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-11
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA104473000OtherUMPI
MNA153907000OtherUMPI