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 1:9403 KENWOOD RD STE A130
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-6880
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9403 KENWOOD RD STE A130
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-6880
Practice Address - Country:US
Practice Address - Phone:513-815-3005
Practice Address - Fax:
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:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care