Provider Demographics
NPI:1508358003
Name:ADVENT HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:ADVENT HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAZEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BALACY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-398-0289
Mailing Address - Street 1:1300 OLIVER RD STE 350
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-3428
Mailing Address - Country:US
Mailing Address - Phone:707-396-0289
Mailing Address - Fax:
Practice Address - Street 1:1300 OLIVER RD STE 350
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534
Practice Address - Country:US
Practice Address - Phone:707-396-0289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-31
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based