Provider Demographics
NPI:1578930616
Name:PRIVA LLC
Entity Type:Organization
Organization Name:PRIVA LLC
Other - Org Name:PRIVA HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MIHIR
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-803-6369
Mailing Address - Street 1:81 BIG OAK RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-7801
Mailing Address - Country:US
Mailing Address - Phone:856-803-6369
Mailing Address - Fax:
Practice Address - Street 1:81 BIG OAK RD
Practice Address - Street 2:SUITE 120
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-7801
Practice Address - Country:US
Practice Address - Phone:856-803-6369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-24
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA28293601261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service