Provider Demographics
NPI:1679058978
Name:ADVANCED CARE UNLIMITED LLC
Entity type:Organization
Organization Name:ADVANCED CARE UNLIMITED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELISABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN-BAPTISTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-212-3095
Mailing Address - Street 1:10556 S US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-5603
Mailing Address - Country:US
Mailing Address - Phone:772-343-1650
Mailing Address - Fax:
Practice Address - Street 1:10556 S US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5603
Practice Address - Country:US
Practice Address - Phone:772-343-1650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-02
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL119398000Medicaid