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General NPI Number Information
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NPI Number | 1639520315
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Entity Type | Organization
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Legal Business Name | AVIVA HOME CARE LLC
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Dates
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Enumeration Date | 06/23/2016
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Last Update Date | 01/04/2017
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Provider Practice Location Address
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Address Line | 4340 E KENTUCKY AVE # 306
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City | DENVER
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State | CO
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Zip | 80246-2060
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Country | US
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Telephone | 720-420-4369
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Fax |
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Provider Business Mailing Address
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Address Line | 4340 E KENTUCKY AVE # 306
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City | DENVER
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State | CO
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Zip | 80246-2060
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Country | US
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Telephone | 720-420-4369
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. LOLA ERKAEVA
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Credential |
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Telephone | 720-217-8607
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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 | 04M642
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License Number State | CO
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