Provider Demographics
NPI:1710726153
Name:KEVIAS HEALTH CARE LLC
Entity type:Organization
Organization Name:KEVIAS HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIKIETA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-322-6943
Mailing Address - Street 1:1952 DILLON DR
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-2521
Mailing Address - Country:US
Mailing Address - Phone:678-322-6943
Mailing Address - Fax:
Practice Address - Street 1:1952 DILLON DR
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-2521
Practice Address - Country:US
Practice Address - Phone:678-322-6943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KEVIASHEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-24
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty