Provider Demographics
NPI:1215150677
Name:NOUVELLE NATION INC
Entity type:Organization
Organization Name:NOUVELLE NATION INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SONY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:ELIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-749-1879
Mailing Address - Street 1:10620 NW 32ND ST
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6852
Mailing Address - Country:US
Mailing Address - Phone:957-749-1879
Mailing Address - Fax:954-237-1177
Practice Address - Street 1:10620 NW 32ND ST
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6852
Practice Address - Country:US
Practice Address - Phone:957-749-1879
Practice Address - Fax:954-237-1177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL9850310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility