Healthcare Provider Details

I. General information

NPI: 1598367336
Provider Name (Legal Business Name): NEVAEH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2020
Last Update Date: 12/16/2020
Certification Date: 12/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 GRAND TRUNK AVE SW STE E
HARTVILLE OH
44632-9681
US

IV. Provider business mailing address

140 GRAND TRUNK AVE SW STE E
HARTVILLE OH
44632-9681
US

V. Phone/Fax

Practice location:
  • Phone: 330-267-6101
  • Fax: 330-267-6101
Mailing address:
  • Phone: 330-267-6101
  • Fax: 330-267-6101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: MRS. AIMEE HARRIS
Title or Position: CEO
Credential:
Phone: 330-475-5831