Provider Demographics
NPI:1871889634
Name:MS.CAVITTA'S CARE
Entity type:Organization
Organization Name:MS.CAVITTA'S CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEZIRE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAVITTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-515-3838
Mailing Address - Street 1:1121 COBURG RD #4
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401
Mailing Address - Country:US
Mailing Address - Phone:541-515-3838
Mailing Address - Fax:
Practice Address - Street 1:1121 COBURG RD #4
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401
Practice Address - Country:US
Practice Address - Phone:541-515-3838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1730353251OtherOWNER'S PREVIOUS NUMBER