Provider Demographics
NPI:1447332770
Name:ADVANCE HEALTH CARE
Entity type:Organization
Organization Name:ADVANCE HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DWAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-709-3832
Mailing Address - Street 1:119 W WHEATLAND RD # A
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4725
Mailing Address - Country:US
Mailing Address - Phone:972-709-3832
Mailing Address - Fax:972-296-1171
Practice Address - Street 1:119 W WHEATLAND RD # A
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4725
Practice Address - Country:US
Practice Address - Phone:972-709-3832
Practice Address - Fax:972-296-1171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007717251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health