Provider Demographics
NPI:1265064497
Name:NOVAK PRIMARY HOME CARE LLC
Entity type:Organization
Organization Name:NOVAK PRIMARY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ARNOLDO
Authorized Official - Middle Name:
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-801-3100
Mailing Address - Street 1:3536 MONTCLAIR ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-2100
Mailing Address - Country:US
Mailing Address - Phone:956-801-3100
Mailing Address - Fax:956-801-3101
Practice Address - Street 1:3536 MONTCLAIR ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-2100
Practice Address - Country:US
Practice Address - Phone:956-801-3100
Practice Address - Fax:956-801-3101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty