Provider Demographics
NPI:1871109900
Name:ADVENT HOME CARE ALLIANCE, INC
Entity type:Organization
Organization Name:ADVENT HOME CARE ALLIANCE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MAXINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GRANSTAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-272-1001
Mailing Address - Street 1:122 E MAIN ST # 164
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33801-4655
Mailing Address - Country:US
Mailing Address - Phone:863-777-9874
Mailing Address - Fax:863-816-3128
Practice Address - Street 1:122 E MAIN ST # 164
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-4655
Practice Address - Country:US
Practice Address - Phone:863-777-9874
Practice Address - Fax:863-816-3128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251V00000XAgenciesVoluntary or Charitable
No385H00000XRespite Care FacilityRespite Care