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NPI Code Detail

MEDICARE: GAVA HEALTHCARE SERVICES, LLC

MEDICARE: GAVA HEALTHCARE SERVICES, 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
1374U00000XHome Health Aide
2376J00000XHomemaker
3385H00000XRespite Care
4253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1639927999
Entity Type Code : Organization
Provider Name (Legal Business Name) : GAVA HEALTHCARE SERVICES, LLC
Provider Business Mailing Address
First Line : 14502 GREENVIEW DR STE 500
Second Line :
City : LAUREL
State : MD
Zip : 20708-4245
Country : US
Telephone Number : 240-202-2321
Fax Number :
Provider Business Practice Location Address
First Line : 14502 GREENVIEW DR STE 500
Second Line :
City : LAUREL
State : MD
Zip : 20708-4245
Country : US
Telephone Number : 240-202-2321
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : VALERIE UKPEH
Credential :
Telephone Number : 240-202-2321
Provider Enumeration Date : 05/10/2024
Last Update Date : 12/30/2024

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Directions to “GAVA HEALTHCARE SERVICES, LLC ” Practice Location

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