Provider Demographics
NPI:1811722911
Name:NOVA LEAP HOME HEALTH FL LLC
Entity type:Organization
Organization Name:NOVA LEAP HOME HEALTH FL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP US OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-561-5686
Mailing Address - Street 1:1593 NORTHAMPTON ST
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-1931
Mailing Address - Country:US
Mailing Address - Phone:413-561-5686
Mailing Address - Fax:
Practice Address - Street 1:27911 CROWN LAKE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-4217
Practice Address - Country:US
Practice Address - Phone:413-561-5686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care