Provider Demographics
NPI:1033876420
Name:NOVA CARELINK LLC
Entity Type:Organization
Organization Name:NOVA CARELINK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEWEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ECCLESTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-912-5825
Mailing Address - Street 1:7968 ALMEDA CT
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-2363
Mailing Address - Country:US
Mailing Address - Phone:703-982-6000
Mailing Address - Fax:
Practice Address - Street 1:7968 ALMEDA CT
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-2363
Practice Address - Country:US
Practice Address - Phone:571-462-7114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-21
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No251J00000XAgenciesNursing CareGroup - Multi-Specialty