Provider Demographics
NPI:1326414483
Name:S&L NOVA INC
Entity Type:Organization
Organization Name:S&L NOVA INC
Other - Org Name:GRISWOLD HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:NOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-254-0672
Mailing Address - Street 1:8344 HALL RD
Mailing Address - Street 2:SUITE 114
Mailing Address - City:UTICA
Mailing Address - State:MI
Mailing Address - Zip Code:48317-5554
Mailing Address - Country:US
Mailing Address - Phone:586-254-0672
Mailing Address - Fax:
Practice Address - Street 1:8344 HALL RD
Practice Address - Street 2:SUITE 114
Practice Address - City:UTICA
Practice Address - State:MI
Practice Address - Zip Code:48317-5554
Practice Address - Country:US
Practice Address - Phone:586-254-0672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health