Provider Demographics
NPI:1588961262
Name:DAVILDA HOME HEALTH, LLC.
Entity type:Organization
Organization Name:DAVILDA HOME HEALTH, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SHAREHOLDER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ORKHOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-685-2712
Mailing Address - Street 1:1515 E. TROPICANA AVENUE
Mailing Address - Street 2:SUITE 340
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6520
Mailing Address - Country:US
Mailing Address - Phone:702-685-2712
Mailing Address - Fax:702-685-2754
Practice Address - Street 1:1515 E. TROPICANA AVENUE
Practice Address - Street 2:SUITE 340
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6520
Practice Address - Country:US
Practice Address - Phone:702-685-2712
Practice Address - Fax:702-685-2754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-16
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6107HHA-0251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV297190Medicare Oscar/Certification