Provider Demographics
NPI:1740018217
Name:PLEASANT VINE HOME CARE LLC
Entity type:Organization
Organization Name:PLEASANT VINE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NOBLE
Authorized Official - Middle Name:
Authorized Official - Last Name:NWOGU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-800-1008
Mailing Address - Street 1:1007 N ORANGE ST 4TH FLOOR
Mailing Address - Street 2:# 119
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-1242
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1007 N ORANGE ST 4TH FLOOR
Practice Address - Street 2:# 119
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1242
Practice Address - Country:US
Practice Address - Phone:302-800-1008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care