Provider Demographics
NPI:1629616560
Name:CAREVANA HEALTH
Entity Type:Organization
Organization Name:CAREVANA HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KERN
Authorized Official - Middle Name:
Authorized Official - Last Name:DE CURRE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:646-421-7951
Mailing Address - Street 1:9740 COVERED WAGON DR APT F
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-1512
Mailing Address - Country:US
Mailing Address - Phone:646-421-7951
Mailing Address - Fax:
Practice Address - Street 1:9740 COVERED WAGON DR APT F
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-1512
Practice Address - Country:US
Practice Address - Phone:646-421-7951
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-11
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health