Healthcare Provider Details

I. General information

NPI: 1124577150
Provider Name (Legal Business Name): HIVA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2016
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 AMHERST ST
WINCHESTER VA
22601-3010
US

IV. Provider business mailing address

1400 AMHERST STREET
WINCHESTER VA
22601
US

V. Phone/Fax

Practice location:
  • Phone: 540-722-8750
  • Fax: 540-722-8752
Mailing address:
  • Phone: 540-722-8750
  • Fax: 540-722-8752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MR. KEITH CLAY
Title or Position: OWNER
Credential:
Phone: 540-722-8750