Provider Demographics
NPI:1770382590
Name:NOVA TECH PLUS
Entity type:Organization
Organization Name:NOVA TECH PLUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PEER TO PEER SUPPORT SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TEDDI
Authorized Official - Middle Name:ANN LARAE
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:FIELD STUDIES
Authorized Official - Phone:951-391-7197
Mailing Address - Street 1:324 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-5988
Mailing Address - Country:US
Mailing Address - Phone:951-391-7198
Mailing Address - Fax:866-218-1053
Practice Address - Street 1:2350 W LATHAM AVENUE
Practice Address - Street 2:GIBBLE PARK
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92545
Practice Address - Country:US
Practice Address - Phone:951-537-9669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AUTHENTICITYINCORG
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-12
Last Update Date:2025-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
No251V00000XAgenciesVoluntary or CharitableGroup - Multi-Specialty
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Multi-Specialty
No333600000XSuppliersPharmacy
No251E00000XAgenciesHome Health
No251K00000XAgenciesPublic Health or Welfare
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No251S00000XAgenciesCommunity/Behavioral Health
No261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty