Organization
ADVANTAGE HOME CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LUCILLE D GOUGH RN, MSN, MBA (PRESIDENT/CEO)
(610) 378-0481
Entity
Organization
Contact information
Practice address
1170 BERKSHIRE BLVD, WYOMISSING, PA 19610-1215
(610) 378-0481
(610) 378-9762
Mailing address
1170 BERKSHIRE BLVD, WYOMISSING, PA 19610-1215
(610) 378-0481
(610) 378-9762
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
N/A
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000074610001
—
PA
01
—
1140
GENTIVA CARE CENTRIX
—
01
—
70139
AAA BRIDGE MONTGOMERY CO
PA
Enumeration date
12/21/2005
Last updated
07/13/2007
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