Provider Demographics
NPI:1770993883
Name:AADVENT COMMUNITY HEALTH SERVICES
Entity type:Organization
Organization Name:AADVENT COMMUNITY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-664-4527
Mailing Address - Street 1:202 E ANTON AVE
Mailing Address - Street 2:STE 206
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-3727
Mailing Address - Country:US
Mailing Address - Phone:208-664-4527
Mailing Address - Fax:208-664-4709
Practice Address - Street 1:202 E ANTON AVE
Practice Address - Street 2:STE 206
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83815-3727
Practice Address - Country:US
Practice Address - Phone:208-664-4527
Practice Address - Fax:208-664-4709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID20004140Medicare UPIN