Organization
ADVANCED HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANNE IVY (MEMBER)
(573) 748-5757
Entity
Organization
Contact information
Practice address
39 VILLA SHOPPING CTR, NEW MADRID, MO 63869-1230
(573) 748-5757
(573) 748-5382
Mailing address
PO BOX 487, NEW MADRID, MO 63869-0487
(573) 748-5757
(573) 748-5382
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
164W00000X
Licensed Practical Nurse
—
—
376J00000X
Homemaker
Primary
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
10/15/2012
Last updated
10/16/2012
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