Provider Demographics
NPI:1801213368
Name:MONTEVISTA HEALTH SERVICES, L.L.C.
Entity Type:Organization
Organization Name:MONTEVISTA HEALTH SERVICES, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SELLERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-918-8012
Mailing Address - Street 1:22093 N 178TH AVE
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85387-9703
Mailing Address - Country:US
Mailing Address - Phone:602-918-8012
Mailing Address - Fax:623-937-8334
Practice Address - Street 1:7971 N 53RD AVE
Practice Address - Street 2:# 106
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-8652
Practice Address - Country:US
Practice Address - Phone:602-918-8012
Practice Address - Fax:623-937-8334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-22
Last Update Date:2014-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health