Provider Demographics
NPI:1831607431
Name:MSK RE HOLDINGS LLC
Entity type:Organization
Organization Name:MSK RE HOLDINGS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDHU
Authorized Official - Suffix:
Authorized Official - Credentials:MS-HSA, BDS
Authorized Official - Phone:386-233-9009
Mailing Address - Street 1:414 S WOODLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-5899
Mailing Address - Country:US
Mailing Address - Phone:386-233-9009
Mailing Address - Fax:386-233-9009
Practice Address - Street 1:414 S WOODLAND BLVD
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-5899
Practice Address - Country:US
Practice Address - Phone:386-233-9009
Practice Address - Fax:386-233-9009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-17
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health