Provider Demographics
NPI:1629610944
Name:DANVILLE SERVICES OF NEVADA, LLC
Entity Type:Organization
Organization Name:DANVILLE SERVICES OF NEVADA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:WOOLSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-316-1121
Mailing Address - Street 1:7351 S UNION PARK AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-1870
Mailing Address - Country:US
Mailing Address - Phone:801-316-1111
Mailing Address - Fax:801-561-3956
Practice Address - Street 1:718 HARDY WAY
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:NV
Practice Address - Zip Code:89027-4300
Practice Address - Country:US
Practice Address - Phone:702-346-1235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DANVILLE SERVICES OF NEVADA, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services