Provider Demographics
NPI:1609761444
Name:CEREVITA LLC
Entity type:Organization
Organization Name:CEREVITA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EMILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VIERA-TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-602-0331
Mailing Address - Street 1:3029 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08105-2837
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3029 CLINTON ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08105-2837
Practice Address - Country:US
Practice Address - Phone:856-602-0331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health