Healthcare Provider Details
I. General information
NPI: 1548101199
Provider Name (Legal Business Name): SANAVITA HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
25300 N 22ND LN APT 1413
PHOENIX AZ
85085-8809
US
IV. Provider business mailing address
25300 N 22ND LN APT 1413
PHOENIX AZ
85085-8809
US
V. Phone/Fax
- Phone: 832-660-1012
- Fax: 832-660-1012
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ABIOLA
OYEMADE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: DNP
Phone: 832-660-1012