Provider Demographics
NPI:1689102493
Name:USVAT ENTERPRISES, LLC
Entity Type:Organization
Organization Name:USVAT ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:USVAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-434-0689
Mailing Address - Street 1:8501 OAKCREEK COVE WAY
Mailing Address - Street 2:
Mailing Address - City:ORANGEVALE
Mailing Address - State:CA
Mailing Address - Zip Code:95662-6003
Mailing Address - Country:US
Mailing Address - Phone:530-434-0689
Mailing Address - Fax:916-200-0385
Practice Address - Street 1:8501 OAKCREEK COVE WAY
Practice Address - Street 2:
Practice Address - City:ORANGEVALE
Practice Address - State:CA
Practice Address - Zip Code:95662-6003
Practice Address - Country:US
Practice Address - Phone:530-434-0689
Practice Address - Fax:916-200-0385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA342700037310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility