Provider Demographics
NPI:1831792688
Name:RV HEALTHCARE LLC
Entity type:Organization
Organization Name:RV HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAYMUND
Authorized Official - Middle Name:R
Authorized Official - Last Name:VELASCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-381-1109
Mailing Address - Street 1:120 SHADY OAK DR
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-6120
Mailing Address - Country:US
Mailing Address - Phone:480-381-1109
Mailing Address - Fax:602-532-7521
Practice Address - Street 1:120 SHADY OAK DR
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-6120
Practice Address - Country:US
Practice Address - Phone:480-381-1109
Practice Address - Fax:602-532-7521
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RV HEALTHCARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-16
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No251E00000XAgenciesHome Health