Healthcare Provider Details

I. General information

NPI: 1477361046
Provider Name (Legal Business Name): SEVA INTEGRATED CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2024
Last Update Date: 12/27/2024
Certification Date: 12/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11448 US 70 BUS HWY W STE B
CLAYTON NC
27520-2208
US

IV. Provider business mailing address

11448 US 70 BUS HWY W STE B
CLAYTON NC
27520-2208
US

V. Phone/Fax

Practice location:
  • Phone: 984-226-9842
  • Fax:
Mailing address:
  • Phone: 984-226-9842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: RODNEY ALPHONSO BYRD
Title or Position: DIRECTOR
Credential:
Phone: 984-226-9842