Provider Demographics
NPI:1609634484
Name:NWANI ADVANCED CARE LLC
Entity type:Organization
Organization Name:NWANI ADVANCED CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LAURATTA
Authorized Official - Middle Name:
Authorized Official - Last Name:LASSANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-581-0128
Mailing Address - Street 1:3855 BLAIR MILL RD APT 247P
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-2896
Mailing Address - Country:US
Mailing Address - Phone:571-581-0128
Mailing Address - Fax:
Practice Address - Street 1:3855 BLAIR MILL RD APT 247P
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-2896
Practice Address - Country:US
Practice Address - Phone:571-581-0128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care