Organization Active NPI

Advance Support LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Forney, TX
National Provider Identifier
1598442212
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
ADVANCE SUPPORT LLC
Practice address
972 Gold Finch LN
Forney, TX 75126-2340
Phone
(225) 938-6657
NPI assigned
Jul 4, 2023
Last updated
Jul 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Authorized official

Name
Motia Dioke Elvis
Title
Ceo
Phone
(225) 938-6657

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NU Primary

Addresses

Primary practice location

972 Gold Finch LN
Forney, TX 75126-2340

Mailing address

300 8TH St SE Unit 472
Altoona, IA 50009-7012

National Provider Directory

National Provider Directory

Locations

300 8th St SE
Unit 472
Altoona, IA 50009

NPI Registry JSON

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

{
    "created_epoch": "1688428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688515200000",
    "number": "1598442212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 8TH ST SE UNIT 472",
            "city": "ALTOONA",
            "state": "IA",
            "postal_code": "500097012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "972 GOLD FINCH LN",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751262340",
            "telephone_number": "225-938-6657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE SUPPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-04",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A",
        "authorized_official_last_name": "DIOKE ELVIS",
        "authorized_official_first_name": "MOTIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "225-938-6657"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forney, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.