Healthcare Provider Details

I. General information

NPI: 1538095906
Provider Name (Legal Business Name): NOVA BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2911 S 87TH DR
TOLLESON AZ
85353-8650
US

IV. Provider business mailing address

2911 S 87TH DR
TOLLESON AZ
85353-8650
US

V. Phone/Fax

Practice location:
  • Phone: 602-384-8605
  • Fax: 877-288-1996
Mailing address:
  • Phone: 602-384-8605
  • Fax: 877-288-1996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: YEMI HELEN OGUNLA
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 602-384-8605