MEDICARE: DIDC INCORPORATED DBA ALL VALLEY HOME HEALTH CARE & NURSING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1912078163
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIDC INCORPORATED DBA ALL VALLEY HOME HEALTH CARE & NURSING

Provider Business Mailing Address
First Line	:	535 S DECATUR BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-3910
Country	:	US
Telephone Number	:	702-562-2273
Fax Number	:

Provider Business Practice Location Address
First Line	:	535 S DECATUR BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-3910
Country	:	US
Telephone Number	:	702-562-2273
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MATTHEW BOLESTA
Credential	:
Telephone Number	:	702-562-2273

Provider Enumeration Date	:	11/10/2006
Last Update Date	:	08/22/2020

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