Healthcare Provider Details

I. General information

NPI: 1689483927
Provider Name (Legal Business Name): GOVA HEALTHCARE SERVICES LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2025
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9350 FALLS OF NEUSE RD STE 201
RALEIGH NC
27615-2481
US

IV. Provider business mailing address

12233 ARNESON ST
RALEIGH NC
27614-6962
US

V. Phone/Fax

Practice location:
  • Phone: 919-949-8956
  • Fax:
Mailing address:
  • Phone: 919-949-8956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CHIKE IFEDIORAH
Title or Position: OWNER/CHIEF EXECUTIVE OFFICER
Credential:
Phone: 919-949-8956