Provider Demographics
NPI:1861988420
Name:SUNVERA HOME CARE LLC
Entity type:Organization
Organization Name:SUNVERA HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EDGARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-576-2660
Mailing Address - Street 1:240 YOUNGS CIR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30215-2765
Mailing Address - Country:US
Mailing Address - Phone:678-576-2660
Mailing Address - Fax:888-965-9774
Practice Address - Street 1:240 YOUNGS CIR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30215-2765
Practice Address - Country:US
Practice Address - Phone:770-462-0450
Practice Address - Fax:888-965-9774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-07
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056-R-1964251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care