Provider Demographics
NPI:1821850074
Name:SIVA HOME HEATHCARE LLC
Entity Type:Organization
Organization Name:SIVA HOME HEATHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OMOYEMI
Authorized Official - Middle Name:
Authorized Official - Last Name:OMOGUNWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-878-6913
Mailing Address - Street 1:7121 QUELLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-8626
Mailing Address - Country:US
Mailing Address - Phone:859-878-6913
Mailing Address - Fax:
Practice Address - Street 1:7121 QUELLIN BLVD
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-8626
Practice Address - Country:US
Practice Address - Phone:859-878-6913
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care