NPIMap

Organization Active NPI

Advantage Home Care LLC

  • Case Management Agency
  • Clay, WV
National Provider Identifier
1124419189
Registry record updated Feb 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
22475308 Issued in WV
Legal business name
ADVANTAGE HOME CARE LLC
Practice address
151 Main Street
Clay, WV 25043
Phone
(304) 587-9992
Fax
(304) 587-9993
NPI assigned
Feb 12, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Crystal Dawn Coulter
Title
Manager
Phone
(304) 587-9992

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 22475308 WV Primary

Addresses

Primary practice location

151 Main Street
Clay, WV 25043

Mailing address

PO Box 835
Clay, WV 25043-0835
Phone (304) 587-9992

National Provider Directory

National Provider Directory
Tax ID family
Advantage Home Care LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423699200000",
    "number": "1124419189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 835",
            "city": "CLAY",
            "state": "WV",
            "postal_code": "250430835",
            "telephone_number": "304-587-9992",
            "fax_number": "304-587-9993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 MAIN STREET",
            "city": "CLAY",
            "state": "WV",
            "postal_code": "25043",
            "telephone_number": "304-587-9992",
            "fax_number": "304-587-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-12",
        "last_updated": "2015-02-12",
        "status": "A",
        "authorized_official_last_name": "COULTER",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "304-587-9992",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "WV",
            "license": "22475308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clay, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.