NOVA IC INC. NPI 1841439650

NPI Information

  • NPI: 1841439650
  • Provider Name: NOVA IC, INC.
  • Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
  • Entity Type: Organization
  • :
  • Address: 135 DAUGHTRY FIELD ROAD
    MOUNT OLIVE, NC
    ZIP 28365
  • Phone: (919) 734-8803

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NPI Details

NOVA IC, INC. is an intermediate care facility mentally retarded in Mount Olive, NC. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. NOVA IC, INC. NPI is 1841439650. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

135 DAUGHTRY FIELD ROAD
MOUNT OLIVE, NC
ZIP 28365-347
Phone: (919) 734-8803
Fax: (919) 735-6825

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 2/18/2009 and was last updated on 10/8/2025.

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
1315P00000XIntermediate Care Facility, Intellectual DisabilitiesMHL-096-037NORTH 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1340609RMEDICAIDNORTH 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: 11/21/2025

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