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General NPI Number Information
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NPI Number | 1396454302
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Entity Type | Organization
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Legal Business Name | AVIVA HOME HEALTH LLC
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Dates
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Enumeration Date | 11/17/2022
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Last Update Date | 11/17/2022
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Provider Practice Location Address
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Address Line | 91 S MAIN ST STE B
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City | SNOWFLAKE
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State | AZ
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Zip | 85937-5285
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Country | US
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Telephone | 928-243-3094
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Fax |
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Provider Business Mailing Address
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Address Line | 91 S MAIN ST STE B
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City | SNOWFLAKE
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State | AZ
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Zip | 85937-5285
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Country | US
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Telephone | 928-243-3094
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRANDON JOHNSON
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Credential |
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Telephone | 928-243-6623
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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