Healthcare Provider Details

I. General information

NPI: 1861054744
Provider Name (Legal Business Name): SAVIDA AGENCY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2019
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4421 ROOSEVELT BLVD STE A
MIDDLETOWN OH
45044-9024
US

IV. Provider business mailing address

PO BOX 291943
NASHVILLE TN
37229-1943
US

V. Phone/Fax

Practice location:
  • Phone: 833-356-4080
  • Fax: 615-237-1434
Mailing address:
  • Phone: 833-952-0829
  • Fax: 615-237-1434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MARINA MAHONEY
Title or Position: VP OF REVENUE CYCLE MANAGEMENT
Credential:
Phone: 913-213-1084