Provider Demographics
NPI:1982841649
Name:INTERCORE DEVELOPMENT INC.
Entity Type:Organization
Organization Name:INTERCORE DEVELOPMENT INC.
Other - Org Name:THE NOVA CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CATINA
Authorized Official - Middle Name:KAWANA
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-881-5514
Mailing Address - Street 1:PO BOX 42326
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77242-2326
Mailing Address - Country:US
Mailing Address - Phone:832-881-5514
Mailing Address - Fax:800-708-7353
Practice Address - Street 1:20911 BRIGHT LAKE BEND CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-4491
Practice Address - Country:US
Practice Address - Phone:832-881-5514
Practice Address - Fax:800-708-7353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty