Provider Demographics
NPI:1831883545
Name:AMERIVITA HOME CARE WEST LLC
Entity type:Organization
Organization Name:AMERIVITA HOME CARE WEST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMIN/CFO
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-462-7670
Mailing Address - Street 1:1553 BOREN DR
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-2989
Mailing Address - Country:US
Mailing Address - Phone:321-281-3038
Mailing Address - Fax:321-284-4933
Practice Address - Street 1:510 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-3657
Practice Address - Country:US
Practice Address - Phone:321-281-3038
Practice Address - Fax:321-284-4933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care