Healthcare Provider Details
I. General information
NPI: 1104768779
Provider Name (Legal Business Name): NOVIAN CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
23790 POINT O WOODS CT
SOUTH LYON MI
48178-9069
US
IV. Provider business mailing address
23790 POINT O WOODS CT
SOUTH LYON MI
48178-9069
US
V. Phone/Fax
- Phone: 734-585-4258
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LEANG
MEY
TAO
Title or Position: MANAGING MEMBER
Credential:
Phone: 734-585-4258