Provider Demographics
NPI: | 1861818643 |
---|---|
Name: | D KLAN, INC. |
Entity Type: | Organization |
Organization Name: | D KLAN, INC. |
Other - Org Name: | CLINICIANS HOME HEALTH CARE SERVICES |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | SERGE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | RAFES |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 702-844-6288 |
Mailing Address - Street 1: | 2770 S MARYLAND PKWY STE 212 |
Mailing Address - Street 2: | |
Mailing Address - City: | LAS VEGAS |
Mailing Address - State: | NV |
Mailing Address - Zip Code: | 89109-1565 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 702-844-6288 |
Mailing Address - Fax: | 702-825-8984 |
Practice Address - Street 1: | 2770 S MARYLAND PKWY STE 212 |
Practice Address - Street 2: | |
Practice Address - City: | LAS VEGAS |
Practice Address - State: | NV |
Practice Address - Zip Code: | 89109-1565 |
Practice Address - Country: | US |
Practice Address - Phone: | 702-844-6288 |
Practice Address - Fax: | 702-825-8984 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2014-03-17 |
Last Update Date: | 2021-02-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NV | NVS7508HHA | 251E00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251E00000X | Agencies | Home Health |