Provider Demographics
NPI:1063607489
Name:ALIVIA CARE SOLUTIONS, INC.
Entity type:Organization
Organization Name:ALIVIA CARE SOLUTIONS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PONDER-STANSEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-407-5050
Mailing Address - Street 1:4266 SUNBEAM ROAD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-6030
Mailing Address - Country:US
Mailing Address - Phone:904-407-7500
Mailing Address - Fax:904-407-6290
Practice Address - Street 1:4266 SUNBEAM ROAD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-6030
Practice Address - Country:US
Practice Address - Phone:904-407-7500
Practice Address - Fax:904-407-6290
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALIVIA CARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-10
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
FL5024096251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251E00000XAgenciesHome Health