Provider Demographics
NPI:1922469097
Name:DANVILLE SERVICES OF NEVADA
Entity Type:Organization
Organization Name:DANVILLE SERVICES OF NEVADA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STATE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-838-0222
Mailing Address - Street 1:9139 W RUSSELL RD STE 110
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-1257
Mailing Address - Country:US
Mailing Address - Phone:702-838-0222
Mailing Address - Fax:702-838-7026
Practice Address - Street 1:9139 W RUSSELL RD STE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-1257
Practice Address - Country:US
Practice Address - Phone:702-838-0222
Practice Address - Fax:702-838-7026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-16
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV9005038748OtherAPI