MEDICARE: ALLEVA HOME CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1336035971
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLEVA HOME CARE

Provider Business Mailing Address
First Line	:	2201 3RD AVE APT 1305
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98121-2005
Country	:	US
Telephone Number	:	206-456-2273
Fax Number	:

Provider Business Practice Location Address
First Line	:	2201 3RD AVE APT 1305
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98121-2005
Country	:	US
Telephone Number	:	206-456-2273
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DR. NISON SIMONTOV
Credential	:
Telephone Number	:	206-456-2273

Provider Enumeration Date	:	06/17/2025
Last Update Date	:	06/17/2025

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