Provider Demographics
NPI:1962791715
Name:SEVA HEALTHCARE, LLC
Entity type:Organization
Organization Name:SEVA HEALTHCARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT, AGENCY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KULVINDER
Authorized Official - Middle Name:KAUR
Authorized Official - Last Name:HIJAZIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-919-0955
Mailing Address - Street 1:1900 ABBOTT ST STE 101
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-4497
Mailing Address - Country:US
Mailing Address - Phone:704-919-0955
Mailing Address - Fax:704-919-0998
Practice Address - Street 1:1900 ABBOTT ST STE 101
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-4497
Practice Address - Country:US
Practice Address - Phone:704-919-0955
Practice Address - Fax:704-919-0998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-01
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3879251F00000X, 251J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418749OtherMEDICAID COMMUNITY ALTERNATIVE PROGRAM