Advanced Home and Community Support Services, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

ADVANCED HOME AND COMMUNITY SUPPORT SERVICES, LLC

Practice address

606 Oriole Blvd Ste 313
Duncanville, TX 75116-3500

Phone

(972) 809-6666

Fax

(972) 283-8037

NPI assigned

Apr 5, 2021

Organization subpart

No

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

Authorized official

Name

Shurla Gay, RN

Title

Program Director

Phone

(972) 809-6666

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617580800000",
    "number": "1871172007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 ORIOLE BLVD STE 313",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751163500",
            "telephone_number": "972-809-6666",
            "fax_number": "972-283-8037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 ORIOLE BLVD STE 313",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751163500",
            "telephone_number": "972-809-6666",
            "fax_number": "972-283-8037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED HOME AND COMMUNITY SUPPORT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-05",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A",
        "authorized_official_last_name": "GAY",
        "authorized_official_first_name": "SHURLA",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "972-809-6666",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Fax",
            "affiliation": "N",
            "endpointDescription": "Fax",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "606 Oriole Blvd Ste 313",
            "city": "Duncanville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "751163500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; 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.