NOVA BEHAVIORAL HEALTH INC. NPI 1164782017

NPI Information

NPI: 1164782017
Provider Name: NOVA BEHAVIORAL HEALTH, INC.

Former Legal Business Name: NOVA HOUSE ASSOCIATION, INC.

Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 36D2201643

Address:
732 BECKMAN ST
DAYTON, OH
ZIP 45410
Phone: (937) 253-1680
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NOVA BEHAVIORAL HEALTH, INC. is a substance abuse rehabilitation facility in Dayton, OH. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. NOVA BEHAVIORAL HEALTH, INC. NPI is 1164782017. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Nova House Association, Inc..

The provider's business location address is:

732 BECKMAN ST
DAYTON, OH
ZIP 45410-165
Phone: (937) 253-1680
Fax: (937) 253-8990

The provider's authorized official is John W Goris .
The authorized official title is Ceo and has the following contact phone number (937) 253-1680.

The CLIA number assigned to this NPI record is 36D2201643 - comp. outpatient rehab facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/25/2012 and was last updated on 5/25/2012.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320800000X	Community Based Residential Treatment Facility, Mental Illness		10-2063	OHIO	No
2	324500000X	Substance Abuse Rehabilitation Facility		1407	OHIO	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2942632	MEDICAID	OHIO

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: 4/28/2024

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