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General NPI Number Information
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NPI Number | 1790459626
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Entity Type | Organization
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Legal Business Name | NOVA SKILLED HOME HEALTH LLC
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Dates
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Enumeration Date | 08/04/2021
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Last Update Date | 08/04/2021
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Provider Practice Location Address
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Address Line | 3300 N SAN FERNANDO BLVD STE 201
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City | BURBANK
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State | CA
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Zip | 91504-2530
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Country | US
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Telephone | 323-658-6232
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Fax |
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Provider Business Mailing Address
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Address Line | 4200 SEPULVEDA BLVD STE 101
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City | CULVER CITY
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State | CA
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Zip | 90230-4742
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JONATHAN SASSOVER
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Credential |
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Telephone | 818-386-6358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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