Healthcare Provider Details

I. General information

NPI: 1891663852
Provider Name (Legal Business Name): NOVA HOMECARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2025
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 S CASWELL AVE
COMPTON CA
90220-3301
US

IV. Provider business mailing address

111 E CARSON ST STE 8
CARSON CA
90745-7728
US

V. Phone/Fax

Practice location:
  • Phone: 323-630-7477
  • Fax:
Mailing address:
  • Phone: 323-630-7477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. STAR WONG-MONROE
Title or Position: CEO
Credential:
Phone: 323-630-7477