Provider Demographics
NPI:1568286037
Name:LAVEN CARE LLC
Entity type:Organization
Organization Name:LAVEN CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FREDA
Authorized Official - Middle Name:ROLANE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-796-9373
Mailing Address - Street 1:612 E PALMER ST
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:TN
Mailing Address - Zip Code:38261-2514
Mailing Address - Country:US
Mailing Address - Phone:731-796-9373
Mailing Address - Fax:270-208-1055
Practice Address - Street 1:201 N HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:KY
Practice Address - Zip Code:42041-1463
Practice Address - Country:US
Practice Address - Phone:270-208-1035
Practice Address - Fax:270-208-1055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty