Provider Demographics
NPI:1619237419
Name:INNOVO HEALTHCARE LLC
Entity Type:Organization
Organization Name:INNOVO HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:PRICCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-396-8831
Mailing Address - Street 1:18242 DOVE COURT
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55347
Mailing Address - Country:US
Mailing Address - Phone:612-396-8831
Mailing Address - Fax:
Practice Address - Street 1:18242 DOVE CT
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55347-1179
Practice Address - Country:US
Practice Address - Phone:612-396-8831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health