Provider Demographics
NPI:1477822310
Name:NEVAEH HOME CARE, LLC
Entity Type:Organization
Organization Name:NEVAEH HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:NICHOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:361-215-0771
Mailing Address - Street 1:14618 RED RIVER DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78410-5623
Mailing Address - Country:US
Mailing Address - Phone:361-215-0771
Mailing Address - Fax:361-356-1855
Practice Address - Street 1:14618 RED RIVER DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-5623
Practice Address - Country:US
Practice Address - Phone:361-215-0771
Practice Address - Fax:361-356-1855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care