Provider Demographics
NPI:1093315871
Name:ENVIGORATI, LLC
Entity Type:Organization
Organization Name:ENVIGORATI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEEANN
Authorized Official - Middle Name:C
Authorized Official - Last Name:EMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:408-870-8506
Mailing Address - Street 1:155 E CAMPBELL AVE STE 224
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-2068
Mailing Address - Country:US
Mailing Address - Phone:408-870-8506
Mailing Address - Fax:
Practice Address - Street 1:155 E CAMPBELL AVE STE 224
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-2068
Practice Address - Country:US
Practice Address - Phone:408-870-8506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health