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Nova Ic, Inc.
Intellectual Disabilities Intermediate Care Facility in La Grange, North Carolina
NPI 1447499330

Nova Ic, Inc. is a Intellectual Disabilities Intermediate Care Facility based in Goldsboro, NC. Nova Ic, Inc. practices in La Grange, NC. The NPI Number for Nova Ic, Inc. is 1447499330 and holds a License No. MHL-054-019 (North Carolina).

The current practice location address for Nova Ic, Inc. is 405 W Washington St, La Grange, NC and can be reached out via phone at 919-734-8803 and via fax at 919-735-6825.

Location: 405 W Washington St, La Grange, NC, 27532-1077
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1447499330
Provider Name
Nova Ic, Inc.
Credential
Provider Entity Type
Organization
Address
405 W Washington St, La Grange, NC, 27532-1077
Phone Number
919-734-8803
Fax Number
919-735-6825
Provider Enumeration Date
02/17/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
3406289 05 NC
institution
Provider Business Practice Location Address Details
Address
405 W Washington St
City
La Grange
State
North Carolina
Zip
28551-1623
Phone Number
919-734-8803
Fax Number
919-735-6825
person
Provider Business Mailing Address Details
Address
405 W Washington St
City
La Grange
State
North Carolina
Zip
28551-1623
Phone Number
919-734-8803
Fax Number
919-735-6825
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
MHL-054-019 (North Carolina)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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