Organization
HOME HEALTH ADVANTAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHIQUITHA CORNELIUS (AUTHORIZING MANAGER)
(574) 274-0152
Entity
Organization
Contact information
Practice address
980 WOODS EDGE DR APT F, NILES, MI 49120-5813
(269) 267-6491
(877) 635-7891
Mailing address
980 WOODS EDGE DR APT F, NILES, MI 49120-5813
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
251G00000X
Community Based Hospice Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
04/18/2018
Last updated
12/07/2020
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