MEDICARE: YOVA LLC

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	1041C0700X	Clinical Social Worker
2	101Y00000X	Counselor

General Provider Information

NPI Number	:	1356123285
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOVA LLC

Provider Business Mailing Address
First Line	:	20131 JAMES COUZENS FWY
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48235-1890
Country	:	US
Telephone Number	:	313-445-4765
Fax Number	:

Provider Business Practice Location Address
First Line	:	20131 JAMES COUZENS FWY
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48235-1890
Country	:	US
Telephone Number	:	313-850-9837
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. KISHVA DANIEL
Credential	:
Telephone Number	:	313-850-9837

Provider Enumeration Date	:	10/16/2023
Last Update Date	:	10/16/2023

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Directions to “YOVA LLC ” Practice Location

Language	Start Address	Practice Location

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