Organization
ADVANCED LIFE MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK CUSTARDO JD (ADMINISTRATOR)
(630) 362-4469
Entity
Organization
Contact information
Practice address
3590 HOBSON RD, SUITE 402, WOODRIDGE, IL 60517-5409
(630) 852-5700
(630) 852-6700
Mailing address
3590 HOBSON RD, SUITE 402, WOODRIDGE, IL 60517-5409
(630) 852-5700
(630) 852-6700
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1011767
IL
Other
Enumeration date
07/25/2016
Last updated
07/25/2016
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