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Individual

TASJANEA K BIVENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8682 BATON ROUGE DR, DAYTON, OH 45424-1041
(937) 260-3484
Mailing address
8682 BATON ROUGE DR, DAYTON, OH 45424-1041
(937) 260-3484

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
172A00000X
Driver
174200000X
Meals Provider
251S00000X
Community/Behavioral Health Agency
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
332U00000X
Home Delivered Meals
343900000X
Non-emergency Medical Transport (VAN)
347C00000X
Private Vehicle
374U00000X
Home Health Aide

Other

Enumeration date
10/11/2022
Last updated
10/11/2022
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