Provider Demographics
NPI:1285347328
Name:DOVE PERSONAL CARE LLC
Entity type:Organization
Organization Name:DOVE PERSONAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:REINIER
Authorized Official - Middle Name:
Authorized Official - Last Name:GANDOL MOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-510-9229
Mailing Address - Street 1:4820 EL ESCORIAL DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-6805
Mailing Address - Country:US
Mailing Address - Phone:702-510-9229
Mailing Address - Fax:
Practice Address - Street 1:4820 EL ESCORIAL DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-6805
Practice Address - Country:US
Practice Address - Phone:702-510-9229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care