Provider Demographics
NPI:1861776643
Name:DESERT VALLEY HOMECARE, INC.
Entity type:Organization
Organization Name:DESERT VALLEY HOMECARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MILES
Authorized Official - Middle Name:
Authorized Official - Last Name:GODA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-452-1510
Mailing Address - Street 1:1091 N PALM CANYON DR
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-4419
Mailing Address - Country:US
Mailing Address - Phone:760-325-9154
Mailing Address - Fax:800-436-6566
Practice Address - Street 1:1091 N PALM CANYON DR
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4419
Practice Address - Country:US
Practice Address - Phone:760-325-9154
Practice Address - Fax:800-436-6566
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEST HEALTH MANAGEMENT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health