Provider Demographics
NPI:1437475712
Name:DESVITO INC
Entity Type:Organization
Organization Name:DESVITO INC
Other - Org Name:THERE'S NO PLACE LIKE HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:T
Authorized Official - Last Name:DEBRITO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-205-9913
Mailing Address - Street 1:17730 CEDAR TRL
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-8214
Mailing Address - Country:US
Mailing Address - Phone:218-205-9913
Mailing Address - Fax:
Practice Address - Street 1:9906 SCOTT AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-5429
Practice Address - Country:US
Practice Address - Phone:612-203-9501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-12
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN348146251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN348146OtherMINNESOTA DEPARTMENT OF HEALTH LICENSE