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NOVA I.C. INC. NPI 1063438695


NPI Information

NPI: 1063438695
Provider Name: NOVA I.C. INC.
Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address:
102 W PATETOWN RD
2307 NORWOOD AVENUE
GOLDSBORO, NC
ZIP 27530
Phone: (919) 751-1083
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NOVA I.C. INC. is a residential treatment facility, intellectual and/or developmental disabilities in Goldsboro, NC. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. NOVA I.C. INC. NPI is 1063438695. The provider is registered as an organization entity type.

The provider's business location address is:

102 W PATETOWN RD
2307 NORWOOD AVENUE
GOLDSBORO, NC
ZIP 27530-415
Phone: (919) 751-1083
Fax: (919) 735-9643

The provider's authorized official is Tracey Pridgen .
The authorized official title is Cfo and has the following contact phone number (919) 734-8803.

The enumeration date for this NPI number is 7/15/2006 and was last updated on 11/13/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1320600000XResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesNORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
16006439MEDICAIDNORTH CAROLINA
28300758BMEDICAIDNORTH CAROLINA
38300822MEDICAIDNORTH CAROLINA
48300826MEDICAIDNORTH CAROLINA
58300826BMEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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