Provider Demographics
NPI:1487625455
Name:ADVANTAGE HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:ADVANTAGE HOME HEALTH CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-516-2270
Mailing Address - Street 1:802 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-3309
Mailing Address - Country:US
Mailing Address - Phone:318-377-4663
Mailing Address - Fax:318-377-4699
Practice Address - Street 1:802 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-3309
Practice Address - Country:US
Practice Address - Phone:318-377-4663
Practice Address - Fax:318-377-4699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-30
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA263251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1402052Medicaid
LA4078740001Medicare NSC