Provider Demographics
NPI:1598930596
Name:NOVA HOME CARE, LLC
Entity Type:Organization
Organization Name:NOVA HOME CARE, LLC
Other - Org Name:AMERICAN QUALITY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-614-8404
Mailing Address - Street 1:1971 TENNESSEE AVE N
Mailing Address - Street 2:
Mailing Address - City:PARSONS
Mailing Address - State:TN
Mailing Address - Zip Code:38363-5049
Mailing Address - Country:US
Mailing Address - Phone:731-847-1356
Mailing Address - Fax:
Practice Address - Street 1:24543 INDOPLEX CIR
Practice Address - Street 2:#100
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-2529
Practice Address - Country:US
Practice Address - Phone:248-549-9800
Practice Address - Fax:248-549-9832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI239007Medicare Oscar/Certification