| NPI | 1972263812 |
|---|---|
| Other Name | NOVA II - RHAWN STREET |
| Entity Type | Organization |
| Authorized Contact | KAYLA HOLLOMAN Quality Assurance Director 267-984-9775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2021-12-20 |
| Last Update Date | 2021-12-20 |