Provider Demographics
NPI:1508269382
Name:DWM VENTURES LLC
Entity Type:Organization
Organization Name:DWM VENTURES LLC
Other - Org Name:LIBERTY HOME HEALTH SERVICES/CASCADE HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATING MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOLPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-734-8914
Mailing Address - Street 1:550 PARK ST
Mailing Address - Street 2:
Mailing Address - City:WEED
Mailing Address - State:CA
Mailing Address - Zip Code:96094-2358
Mailing Address - Country:US
Mailing Address - Phone:530-408-3017
Mailing Address - Fax:866-352-2442
Practice Address - Street 1:550 PARK ST
Practice Address - Street 2:
Practice Address - City:WEED
Practice Address - State:CA
Practice Address - Zip Code:96094-2358
Practice Address - Country:US
Practice Address - Phone:530-408-3017
Practice Address - Fax:866-352-2442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-07
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA75376OtherSTATE OF CALIFORNIA , DEPARTMENT OF PUBLIC HEALTH, FOOD AND DRUG BRANCH, HMDR