Provider Demographics
NPI:1790116135
Name:NOVAE LLC
Entity Type:Organization
Organization Name:NOVAE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-667-7778
Mailing Address - Street 1:4200 N GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-2220
Mailing Address - Country:US
Mailing Address - Phone:970-667-7778
Mailing Address - Fax:970-667-4383
Practice Address - Street 1:4200 N GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-2220
Practice Address - Country:US
Practice Address - Phone:970-667-7778
Practice Address - Fax:970-667-4383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04P680251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health