Provider Demographics
NPI:1073219572
Name:PRIVIS HEALTH
Entity Type:Organization
Organization Name:PRIVIS HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANY
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:603-785-0212
Mailing Address - Street 1:4819 EMPEROR BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-5420
Mailing Address - Country:US
Mailing Address - Phone:603-785-0212
Mailing Address - Fax:
Practice Address - Street 1:4819 EMPEROR BLVD STE 400
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-5420
Practice Address - Country:US
Practice Address - Phone:603-785-0212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management