Provider Demographics
NPI:1043720725
Name:CLINIVA HEALTH, LLC
Entity type:Organization
Organization Name:CLINIVA HEALTH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMBRA
Authorized Official - Middle Name:RE'SHAY
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA, BS, RRT
Authorized Official - Phone:912-667-6358
Mailing Address - Street 1:4720 CUMBERLAND DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-5116
Mailing Address - Country:US
Mailing Address - Phone:912-667-6358
Mailing Address - Fax:
Practice Address - Street 1:4720 CUMBERLAND DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-5116
Practice Address - Country:US
Practice Address - Phone:912-667-6358
Practice Address - Fax:912-352-9871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-06
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care