Provider Demographics
NPI:1477051001
Name:CARETIVO LLC
Entity Type:Organization
Organization Name:CARETIVO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GBENGA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLUWASESIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-554-6635
Mailing Address - Street 1:8033 BROCKMAN LN
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-2591
Mailing Address - Country:US
Mailing Address - Phone:615-554-6635
Mailing Address - Fax:
Practice Address - Street 1:8033 BROCKMAN LN
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-2591
Practice Address - Country:US
Practice Address - Phone:615-554-6635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care