MEDICARE: SANAVITA HEALTHCARE 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	251S00000X	Community/Behavioral Health Agency
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1548101199
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANAVITA HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	25300 N 22ND LN APT 1413
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85085-8809
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	25300 N 22ND LN APT 1413
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85085-8809
Country	:	US
Telephone Number	:	832-660-1012
Fax Number	:	832-660-1012

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	ABIOLA OYEMADE
Credential	:	DNP
Telephone Number	:	832-660-1012

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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