Provider Demographics
NPI:1609648757
Name:TIVA ASSOCIATES, LLC
Entity Type:Organization
Organization Name:TIVA ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:COUTURE
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:734-241-3891
Mailing Address - Street 1:4014 DURHAM RD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-1957
Mailing Address - Country:US
Mailing Address - Phone:248-709-6259
Mailing Address - Fax:
Practice Address - Street 1:43475 DALCOMA DR STE 150
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-3594
Practice Address - Country:US
Practice Address - Phone:248-709-6289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty