Provider Demographics
NPI:1699172288
Name:SAVAN HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:SAVAN HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KHAMBONE
Authorized Official - Middle Name:
Authorized Official - Last Name:VATHANANONH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-736-1439
Mailing Address - Street 1:4209 BROADWAY AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HALTOM CITY
Mailing Address - State:TX
Mailing Address - Zip Code:76117-3546
Mailing Address - Country:US
Mailing Address - Phone:614-736-1439
Mailing Address - Fax:
Practice Address - Street 1:4209 BROADWAY AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:HALTOM CITY
Practice Address - State:TX
Practice Address - Zip Code:76117-3546
Practice Address - Country:US
Practice Address - Phone:614-736-1439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-25
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health