Organization
ADVANCE HEALTHCARE PROVIDERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAPHET MUTANGA (ADMINISTRATOR)
(240) 606-0242
Entity
Organization
Contact information
Practice address
2709 PUMPKIN ST, CLINTON, MD 20735-1057
(240) 606-0242
Mailing address
2709 PUMPKIN ST, CLINTON, MD 20735-1057
(240) 606-0242
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
164W00000X
Licensed Practical Nurse
—
—
253Z00000X
In Home Supportive Care Agency
—
—
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
04/03/2019
Last updated
04/03/2019
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