Organization
ADV SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA DOMINIQUE (MANAGER)
(740) 658-3362
Entity
Organization
Contact information
Practice address
14400 STONEGATE MANOR DR, GONZALES, LA 70737-7593
(740) 658-3362
(567) 210-2640
Mailing address
14400 STONEGATE MANOR DR, GONZALES, LA 70737-7593
(740) 658-3362
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821562216
—
OH
Enumeration date
05/27/2024
Last updated
05/27/2024
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