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General NPI Number Information
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NPI Number | 1063197382
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Entity Type | Organization
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Legal Business Name | NOVA VITAE, INC.
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Dates
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Enumeration Date | 06/15/2023
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 5985 TOPANGA CANYON BLVD
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-3623
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Country | US
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Telephone | 818-422-3442
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Fax |
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Provider Business Mailing Address
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Address Line | 5958 TOPANGA CANYON BLVD
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City | WOODLAND HILLS
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State | CA
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Zip | 91367
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Country | US
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Telephone | 818-961-7722
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALEX YADEGAR
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Credential |
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Telephone | 818-961-7722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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