Provider Demographics
NPI:1619102415
Name:SENIOR ADVANTAGE HOMECARE, INC.
Entity type:Organization
Organization Name:SENIOR ADVANTAGE HOMECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:AMENDOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-795-6316
Mailing Address - Street 1:1601 E LAMAR BLVD STE 109
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-4465
Mailing Address - Country:US
Mailing Address - Phone:817-795-6316
Mailing Address - Fax:817-795-6318
Practice Address - Street 1:1601 E LAMAR BLVD STE 109
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-4465
Practice Address - Country:US
Practice Address - Phone:817-795-6316
Practice Address - Fax:817-795-6318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-21
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011402253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care