MEDICARE: NOVA ALL STAR, 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
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1932839453
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOVA ALL STAR, INC.

Provider Business Mailing Address
First Line	:	5525 ROSE THICKET ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-1653
Country	:	US
Telephone Number	:	702-882-7736
Fax Number	:	702-633-8928

Provider Business Practice Location Address
First Line	:	5525 ROSE THICKET ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-1653
Country	:	US
Telephone Number	:	702-882-7736
Fax Number	:	702-633-8928

Authorized Official
Title or Position	:	PRESIDENT
Name	:	FRANKLIN FONTILLAS
Credential	:
Telephone Number	:	702-882-7736

Provider Enumeration Date	:	06/16/2022
Last Update Date	:	06/16/2022

Similar Medicare Providers

1083343560 — FRANKLIN FONTILLAS
Practice Location Address:

5525 ROSE THICKET ST
LAS VEGAS, NV
89130-1653

Practice Phone: 702-882-7736
Practice Fax: 702-633-8928

1871878744 — ANTHONY MADDEN
Practice Location Address:

1707 SPOTTED PONY DR
NORTH LAS VEGAS, NV
89031-1653

Practice Phone: 702-275-3635
Practice Fax:

1356991715 — EBONY J WASHINGTON
Practice Location Address:

1205 N JONES BLVD APT 102
LAS VEGAS, NV
89108-1653

Practice Phone: 213-453-9333
Practice Fax:

1285484022 — YULIET LAZO DIAZ
Practice Location Address:

3642 BOULDER HWY
LAS VEGAS, NV
89121-1653

Practice Phone: 786-735-7406
Practice Fax:

1770435026 — CRYSTAL DEL VALLE LMSW
Practice Location Address:

2560 DESERT COVE PL
LAS CRUCES, NM
88011-1653

Practice Phone: 575-551-2595
Practice Fax:

1396697660 — ANA MARTINEZ HERNANDEZ
Practice Location Address:

3680 N RANCHO DR
LAS VEGAS, NV
89130-3180

Practice Phone: 702-646-5437
Practice Fax: 702-396-4193

Directions to “NOVA ALL STAR, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.