Provider Demographics
NPI:1720460322
Name:A NOVO CARE
Entity Type:Organization
Organization Name:A NOVO CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:AKIKO
Authorized Official - Middle Name:
Authorized Official - Last Name:COOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-367-2366
Mailing Address - Street 1:2575 S CIMARRON RD STE 104
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2682
Mailing Address - Country:US
Mailing Address - Phone:702-476-2899
Mailing Address - Fax:
Practice Address - Street 1:2575 S CIMARRON RD STE 104
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2682
Practice Address - Country:US
Practice Address - Phone:702-476-2899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health