Provider Demographics
NPI:1700598778
Name:DEKTOS LLC
Entity Type:Organization
Organization Name:DEKTOS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:919-263-1165
Mailing Address - Street 1:1241 S MAIN ST STE 24B
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-9494
Mailing Address - Country:US
Mailing Address - Phone:919-263-1165
Mailing Address - Fax:984-401-0500
Practice Address - Street 1:1241 S MAIN ST STE 24B
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-9494
Practice Address - Country:US
Practice Address - Phone:919-263-1165
Practice Address - Fax:984-401-0500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty