Provider Demographics
NPI:1609505510
Name:DVR HOMECARE LLC
Entity Type:Organization
Organization Name:DVR HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-548-9000
Mailing Address - Street 1:5700 BROOKGLEN DR APT 562
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77017-5814
Mailing Address - Country:US
Mailing Address - Phone:215-548-9000
Mailing Address - Fax:
Practice Address - Street 1:5700 BROOKGLEN DR APT 562
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77017-5814
Practice Address - Country:US
Practice Address - Phone:215-548-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health