Healthcare Provider Details
I. General information
NPI: 1134308083
Provider Name (Legal Business Name): DVAR TOVE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/29/2007
Last Update Date: 10/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
182 W 9TH ST
HIALEAH FL
33010-4015
US
IV. Provider business mailing address
140 W 28TH ST
HIALEAH FL
33010-1606
US
V. Phone/Fax
- Phone: 305-887-8095
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3104A0625X |
| Taxonomy | Assisted Living Facility (Mental Illness) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CLAUDIA
PACE
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 305-863-0002