Provider Demographics
NPI:1811275134
Name:VALHALLA ENTERPRISES, LLC
Entity type:Organization
Organization Name:VALHALLA ENTERPRISES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:WOGSLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-837-3100
Mailing Address - Street 1:5B COMMERCIAL PLACE
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:30022
Mailing Address - Country:US
Mailing Address - Phone:843-837-3100
Mailing Address - Fax:843-837-3104
Practice Address - Street 1:5B COMMERCIAL PLACE
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:30022
Practice Address - Country:US
Practice Address - Phone:843-837-3100
Practice Address - Fax:843-837-3104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care