Provider Demographics
NPI:1770168346
Name:MIGHTY CAREGIVERS LLC
Entity type:Organization
Organization Name:MIGHTY CAREGIVERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GUY
Authorized Official - Middle Name:V
Authorized Official - Last Name:PREVOST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-210-4580
Mailing Address - Street 1:219 WILBUR BLOOM BLVD
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18302-8698
Mailing Address - Country:US
Mailing Address - Phone:347-210-4580
Mailing Address - Fax:
Practice Address - Street 1:219 WILBUR BLOOM BLVD
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18302-8698
Practice Address - Country:US
Practice Address - Phone:347-210-4580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care