Provider Demographics
NPI:1902473580
Name:ADVANCED CARE SERVICES SAVANNAH INC
Entity Type:Organization
Organization Name:ADVANCED CARE SERVICES SAVANNAH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:DE TERREFORTE-DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:787-903-9856
Mailing Address - Street 1:6606 ABERCORN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-5831
Mailing Address - Country:US
Mailing Address - Phone:786-488-9030
Mailing Address - Fax:
Practice Address - Street 1:6606 ABERCORN ST STE 101
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-5831
Practice Address - Country:US
Practice Address - Phone:786-488-9030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-10
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care