Provider Demographics
NPI:1780026617
Name:VALEO HOSPICE LLC
Entity Type:Organization
Organization Name:VALEO HOSPICE LLC
Other - Org Name:VALEO HOME HEALTH AND HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:RADICS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-787-1570
Mailing Address - Street 1:5250 S COMMERCE DR STE 225
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-7926
Mailing Address - Country:US
Mailing Address - Phone:801-639-0020
Mailing Address - Fax:801-629-0021
Practice Address - Street 1:5250 S COMMERCE DR STE 225
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-7926
Practice Address - Country:US
Practice Address - Phone:801-639-0020
Practice Address - Fax:801-629-0021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-19
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2013HOSPICEUT00059251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT461604Medicare Oscar/Certification