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NPI Code Detail

MEDICARE: NOVA BEHAVIORAL HEALTH, INC

MEDICARE: NOVA BEHAVIORAL HEALTH, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1324500000XSubstance Abuse Rehabilitation FacilityPROVIDER 1407OH
2320800000XMental Illness Community Based Residential Treatment Facility10-2063OH
3324500000XSubstance Abuse Rehabilitation Facility1407OH

General Provider Information

NPI Number : 1548217748
Entity Type Code : Organization
Provider Name (Legal Business Name) : NOVA BEHAVIORAL HEALTH, INC
Provider Business Mailing Address
First Line : 732 BECKMAN STREET
Second Line :
City : DAYTON
State : OH
Zip : 45410-2165
Country : US
Telephone Number : 937-253-1680
Fax Number : 937-252-1337
Provider Business Practice Location Address
First Line : 732 BECKMAN STREET
Second Line :
City : DAYTON
State : OH
Zip : 45410-2165
Country : US
Telephone Number : 937-253-1680
Fax Number : 937-252-1337
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : MR. HERBERT RICKABAUGH
Credential :
Telephone Number : 937-253-1680
Provider Enumeration Date : 05/31/2006
Last Update Date : 09/07/2012

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Directions to “NOVA BEHAVIORAL HEALTH, INC ” Practice Location

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