Provider Demographics
NPI:1558891317
Name:NOVENA HEALTHCARE LLC
Entity Type:Organization
Organization Name:NOVENA HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BIBIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:EZEONYIM
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:240-426-0447
Mailing Address - Street 1:6 PIDGEON HILL DR STE 240
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-6147
Mailing Address - Country:US
Mailing Address - Phone:240-426-0447
Mailing Address - Fax:703-421-5750
Practice Address - Street 1:6 PIDGEON HILL DR STE 240
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-6147
Practice Address - Country:US
Practice Address - Phone:240-426-0447
Practice Address - Fax:703-421-5750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health