Advantage Home Care, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

HP0058600 Issued in NJ

Legal business name

ADVANTAGE HOME CARE, LLC

Practice address

270 State Street
Hackensack, NJ 07601

Phone

(201) 489-4899

NPI assigned

Mar 22, 2007

Last updated

Apr 19, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Leonard Verkhoglaz

Title

Principal

Phone

(201) 489-4899

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334793600000",
    "number": "1164548871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 STATE STREET",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "07601",
            "telephone_number": "201-489-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 STATE STREET",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "07601",
            "telephone_number": "201-489-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2012-04-19",
        "status": "A",
        "authorized_official_last_name": "VERKHOGLAZ",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "201-489-4899",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NJ",
            "license": "HP0058600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0061646",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2012; 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.