Provider Demographics
NPI:1528469590
Name:ADVANTAGE HOME HEALTH CARE AGENCY, LLC
Entity type:Organization
Organization Name:ADVANTAGE HOME HEALTH CARE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:540-623-1159
Mailing Address - Street 1:8001 SANDALWOOD LN
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-7316
Mailing Address - Country:US
Mailing Address - Phone:540-623-1159
Mailing Address - Fax:
Practice Address - Street 1:607 WILLIAM ST
Practice Address - Street 2:SUITE 108
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-5773
Practice Address - Country:US
Practice Address - Phone:540-623-1159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-10
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO151182251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health