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Organization

ADVANTAGE HOME HEALTH CARE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JACKIE L MICHAEL (CEO)
(765) 284-1211
Entity
Organization

Contact information

Practice address
4008 N WHEELING AVE, MUNCIE, IN 47304-1427
(765) 284-1211
(765) 284-1239
Mailing address
4008 N WHEELING AVE, MUNCIE, IN 47304-1427
(765) 284-1211
(765) 284-1239

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
007116
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000098092
ANTHEM BC/BS
05
100374770
IN
01
100374780
MEDICAID WAIVER
IN
Enumeration date
10/27/2005
Last updated
01/11/2010
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