| Nova | |
|
4425 W Olive Ave Suite 200 Glendale AZ 85302-3843 | |
| (623) 937-9203 | |
| (623) 930-0358 |
| Full Name | Nova |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4425 W Olive Ave, Glendale, Arizona |
| Authorized Official Name and Position | Mary E Oconnor (DIRECTOR OF FINANCE) |
| Authorized Official Contact | 6239379203 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nova 4425 W Olive Ave Suite 200 Glendale AZ 85302-3843 Ph: (623) 937-9203 | Nova 4425 W Olive Ave Suite 200 Glendale AZ 85302-3843 Ph: (623) 937-9203 |
| NPI Number | 1861561375 |
|---|---|
| Provider Enumeration Date | 11/07/2006 |
| Last Update Date | 06/25/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861561375 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | BH3380 (Arizona) | Primary |
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