Healthcare Provider Details

I. General information

NPI: 1902304884
Provider Name (Legal Business Name): NOVA ADULT DAY CARE CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2018
Last Update Date: 07/23/2021
Certification Date: 07/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44675 CAPE CT STE 130
ASHBURN VA
20147-6230
US

IV. Provider business mailing address

44675 CAPE CT STE 130
ASHBURN VA
20147-6230
US

V. Phone/Fax

Practice location:
  • Phone: 703-433-8888
  • Fax: 703-433-1111
Mailing address:
  • Phone: 703-433-8888
  • Fax: 703-433-1111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JIHONG WANG
Title or Position: OWNER
Credential:
Phone: 703-433-8888