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NPI Code Detail

MEDICARE: NOVA CENTER INC.

MEDICARE: NOVA CENTER INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0850XAdult Mental Health Clinic/Center902MO
2261QA0600XAdult Day Care Clinic/Center902MO
3320600000XIntellectual and/or Developmental Disabilities Residential Treatment Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154541761
Entity Type Code : Organization
Provider Name (Legal Business Name) : NOVA CENTER INC.
Provider Business Mailing Address
First Line : 8401 HICKMAN MILLS DR
Second Line :
City : KANSAS CITY
State : MO
Zip : 64132-2513
Country : US
Telephone Number : 816-761-8614
Fax Number : 816-765-0622
Provider Business Practice Location Address
First Line : 8401 HICKMAN MILLS DR
Second Line :
City : KANSAS CITY
State : MO
Zip : 64132-2513
Country : US
Telephone Number : 816-761-8614
Fax Number : 816-765-0622
Authorized Official
Title or Position : CEO
Name : MR. CARY WILLIAMS
Credential :
Telephone Number : 816-761-8614
Provider Enumeration Date : 04/26/2007
Last Update Date : 01/06/2011

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Practice Location Address:
8401 HICKMAN MILLS DR
KANSAS CITY, MO
64132-2513
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Practice Fax: 816-765-0622
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