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General NPI Number Information
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NPI Number | 1184299448
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Entity Type | Organization
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Legal Business Name | SEVA HOME CARE LLC
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Dates
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Enumeration Date | 05/20/2021
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Last Update Date | 05/20/2021
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Provider Practice Location Address
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Address Line | 5675 JIMMY CARTER BLVD STE 665A
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City | NORCROSS
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State | GA
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Zip | 30071-2955
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Country | US
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Telephone | 440-556-2754
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Fax |
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Provider Business Mailing Address
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Address Line | 510 BUTLER NATIONAL DR
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City | JOHNS CREEK
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State | GA
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Zip | 30097-5944
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Country | US
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Telephone | 770-317-4533
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | POONAM DATTA
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Credential |
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Telephone | 770-317-4533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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