Healthcare Provider Details

I. General information

NPI: 1013540624
Provider Name (Legal Business Name): NOVA HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2020
Last Update Date: 02/21/2020
Certification Date: 02/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 SEMINOLE CIR
LAREDO TX
78045-4133
US

IV. Provider business mailing address

507 SEMINOLE CIR
LAREDO TX
78045-4133
US

V. Phone/Fax

Practice location:
  • Phone: 956-775-2009
  • Fax:
Mailing address:
  • Phone: 956-775-2009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: VALERIA LEAL
Title or Position: ADMINISTRATOR
Credential:
Phone: 956-775-2009