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General NPI Number Information
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NPI Number | 1255156592
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Entity Type | Organization
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Legal Business Name | VALIANT ENDEAVORS LLC
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 12/24/2024
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Provider Practice Location Address
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Address Line | 1021 CONNECTICUT ST
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City | LAWRENCE
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State | KS
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Zip | 66044-3037
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Country | US
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Telephone | 773-800-1574
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Fax |
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Provider Business Mailing Address
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Address Line | 5830 LYMAN AVE
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City | DOWNERS GROVE
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State | IL
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Zip | 60516-1403
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Country | US
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Telephone | 773-800-1574
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MATTHEW LARSEN
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Credential |
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Telephone | 773-800-1574
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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