Provider Demographics
NPI:1952094401
Name:KAV HEALTH GROUP LLC
Entity type:Organization
Organization Name:KAV HEALTH GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VINCE
Authorized Official - Middle Name:
Authorized Official - Last Name:DENITTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-815-3005
Mailing Address - Street 1:5563 FAR HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45429-2225
Mailing Address - Country:US
Mailing Address - Phone:937-291-2300
Mailing Address - Fax:937-291-2303
Practice Address - Street 1:5563 FAR HILLS AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-2225
Practice Address - Country:US
Practice Address - Phone:937-291-2300
Practice Address - Fax:937-291-2303
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KAV HEALTH GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-31
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care