Organization
ADVANTAGE IN-HOME SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN P BOSEN (CEO)
(314) 282-2957
Entity
Organization
Contact information
Practice address
11796 WESTLINE INDUSTRIAL DR, SAINT LOUIS, MO 63146-3402
(314) 282-2957
(314) 282-2967
Mailing address
11796 WESTLINE INDUSTRIAL DR, SAINT LOUIS, MO 63146-3402
(314) 282-2957
(314) 282-2967
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
09/24/2008
Last updated
06/13/2023
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