Provider Demographics
NPI:1689429987
Name:DZINESCO HOME DESIGN, LLC.
Entity type:Organization
Organization Name:DZINESCO HOME DESIGN, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-765-0777
Mailing Address - Street 1:1100 E MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-4063
Mailing Address - Country:US
Mailing Address - Phone:970-765-0777
Mailing Address - Fax:
Practice Address - Street 1:1100 E MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-4063
Practice Address - Country:US
Practice Address - Phone:970-765-0777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management