# ADVANCED LIFE MANAGEMENT LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710430855
- **Authorized official:** PATRICK CUSTARDO JD (ADMINISTRATOR)
- **Authorized official phone:** (630) 362-4469

## Contact information

- **Practice address:** 3590 HOBSON RD, SUITE 402, WOODRIDGE, IL 60517-5409
- **Practice address phone:** (630) 852-5700
- **Practice address fax:** (630) 852-6700
- **Mailing address:** 3590 HOBSON RD, SUITE 402, WOODRIDGE, IL 60517-5409
- **Mailing address phone:** (630) 852-5700
- **Mailing address fax:** (630) 852-6700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 1011767 | IL | Yes |

## Other

- **Enumeration date:** 07/25/2016
- **Last updated:** 07/25/2016