Provider Demographics
NPI:1619333739
Name:RV HEALTHCARE LLC
Entity Type:Organization
Organization Name:RV HEALTHCARE LLC
Other - Org Name:THERAPEUTIC TKD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAYMUND
Authorized Official - Middle Name:
Authorized Official - Last Name:VELASCO
Authorized Official - Suffix:
Authorized Official - Credentials:PT,MA
Authorized Official - Phone:480-381-1109
Mailing Address - Street 1:2421 E JUDE LN
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85298-0462
Mailing Address - Country:US
Mailing Address - Phone:480-381-1109
Mailing Address - Fax:
Practice Address - Street 1:3281 E IVANHOE ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-3405
Practice Address - Country:US
Practice Address - Phone:480-381-1109
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-05
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPT 7731251E00000X
261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No251E00000XAgenciesHome Health