Provider Demographics
NPI:1821266099
Name:DND HEALTHCARE, LLC
Entity Type:Organization
Organization Name:DND HEALTHCARE, LLC
Other - Org Name:BRIGHTSTAR HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:HARTVICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-620-6011
Mailing Address - Street 1:10160 SW NIMBUS AVE
Mailing Address - Street 2:BLDG F-4
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-4338
Mailing Address - Country:US
Mailing Address - Phone:503-620-6011
Mailing Address - Fax:503-620-6199
Practice Address - Street 1:10160 SW NIMBUS AVE
Practice Address - Street 2:BLDG F-4
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-4338
Practice Address - Country:US
Practice Address - Phone:503-620-6011
Practice Address - Fax:503-620-6199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR13-1394251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health