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General NPI Number Information
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NPI Number | 1750460739
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Entity Type | Organization
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Legal Business Name | DYNAMIC HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 11/08/2010
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Provider Practice Location Address
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Address Line | 2865 S. JONES
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City | LAS VEGAS
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State | NV
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Zip | 39146
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Country | US
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Telephone | 702-388-7070
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Fax | 702-388-2525
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Provider Business Mailing Address
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Address Line | 2865 S. JONES
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City | LAS VEGAS
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State | NV
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Zip | 39146
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Country | US
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Telephone | 702-388-7070
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Fax | 702-388-2525
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Authorized Official
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Title or Position | CEO/CFO
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Name | DR. NISSAN PARDO
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Credential | PH.D
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Telephone | 818-931-4446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 534HHA-8
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License Number State | NV
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