Provider Demographics
NPI:1013661818
Name:NOVA HOME SUPPORT
Entity Type:Organization
Organization Name:NOVA HOME SUPPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MIKAYLA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:NAPIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-821-1770
Mailing Address - Street 1:172 SANTA CRUZ RDG
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95033-9048
Mailing Address - Country:US
Mailing Address - Phone:509-821-1770
Mailing Address - Fax:
Practice Address - Street 1:172 SANTA CRUZ RDG
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95033-9048
Practice Address - Country:US
Practice Address - Phone:509-821-1770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health