Provider Demographics
NPI:1285928937
Name:NOVACARE HOME HEALTH SERVICES
Entity type:Organization
Organization Name:NOVACARE HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATOR/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:INNOCENT
Authorized Official - Middle Name:DOZIE
Authorized Official - Last Name:MOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-638-6773
Mailing Address - Street 1:1628 WAR HORSE LN
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-8629
Mailing Address - Country:US
Mailing Address - Phone:512-638-6773
Mailing Address - Fax:
Practice Address - Street 1:1628 WAR HORSE LN
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-8629
Practice Address - Country:US
Practice Address - Phone:512-638-6773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOVACARE HEALTH SERVICES CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-30
Last Update Date:2011-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health