Provider Demographics
NPI:1508525320
Name:VETERANS LIVING ABROAD LLC
Entity Type:Organization
Organization Name:VETERANS LIVING ABROAD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-435-5908
Mailing Address - Street 1:2527 CAPELLA STAR ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89044-4431
Mailing Address - Country:US
Mailing Address - Phone:849-450-3533
Mailing Address - Fax:
Practice Address - Street 1:PLAZA MILANO C. ANTERA MOTA
Practice Address - Street 2:3 NIEVEL
Practice Address - City:PUERTO PLATA
Practice Address - State:PUERTO PLATA
Practice Address - Zip Code:57000
Practice Address - Country:DO
Practice Address - Phone:849-450-3533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVE19455062021-2OtherE19455062021-2