| Organization Name: | ADVANGARDE |
| NPI Number: | 1073999413 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SCOTT WINSTON CARTER (PRESIDENT) |
| Mailing Address: | 604 S Washington Sq Philadelphia |
| State: | PA US |
| Postal Code: | 191064118 |
| Phone Number: | 6092540626 |
| Fax Number: | 6092540621 |
| NPI Enumeration Date: | 08/08/2015 |
| NPI Last Update Date: | 08/08/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251V00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Voluntary or Charitable |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |