MEDICARE: SEVA FAMILY CAREGIVER 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1689394439
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEVA FAMILY CAREGIVER LLC

Provider Business Mailing Address
First Line	:	510 BUTLER NATIONAL DR
Second Line	:
City	:	JOHNS CREEK
State	:	GA
Zip	:	30097-5944
Country	:	US
Telephone Number	:	404-556-2754
Fax Number	:

Provider Business Practice Location Address
First Line	:	5675 JIMMY CARTER BLVD STE 665A
Second Line	:
City	:	NORCROSS
State	:	GA
Zip	:	30071-2955
Country	:	US
Telephone Number	:	404-556-2754
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CHIRAG DATTA
Credential	:
Telephone Number	:	404-556-2754

Provider Enumeration Date	:	08/31/2022
Last Update Date	:	08/31/2022

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Directions to “SEVA FAMILY CAREGIVER LLC ” Practice Location

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