Provider Demographics
NPI:1366914061
Name:RAPHA NOVA HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:RAPHA NOVA HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CLARENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-777-1718
Mailing Address - Street 1:4141 HORIZON NORTH PKWY APT 721
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-2829
Mailing Address - Country:US
Mailing Address - Phone:469-777-1718
Mailing Address - Fax:
Practice Address - Street 1:4141 HORIZON NORTH PKWY APT 721
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-2829
Practice Address - Country:US
Practice Address - Phone:469-777-1718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care