Organization Name: | DESERT VALLEY HEALTHCARE LLC |
NPI Number: | 1205285442 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL R TAYLOR (MANAGING MEMBER) |
Mailing Address: | 2250 Postal Dr Ste 4 Pahrump |
State: | NV US |
Postal Code: | 890484798 |
Phone Number: | 7757278900 |
Fax Number: | 7757279452 |
NPI Enumeration Date: | 06/08/2016 |
NPI Last Update Date: | 06/08/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0100X |
License Number: | 8408 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NV |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Health Service |
Taxonomy Definition: |