Healthcare Provider Details

I. General information

NPI: 1285577148
Provider Name (Legal Business Name): SANAVITA HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
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

Practice location:
  • Phone: 832-660-1012
  • Fax:
Mailing address:
  • Phone: 832-660-1012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ABIOLA OYEMADE
Title or Position: CEO
Credential: DNP
Phone: 832-660-1012