Club Nova Community, Inc

LBN: Club Nova Community, Inc
Club Nova Community, Inc is an health care organization with primary practice located at 103 W Main St Suite D, Carrboro NC 27510-2072. The organization recently has only one registered license in Ambulatory Health Care Facilities / Adult Mental Health, which is considered as the primary health care specialty. Club Nova Community, Inc can be contacted via phone (919) 968-6682, or through Long, Jacob via phone (919) 968-6682.

Contact Information

Primary practice address
103 W Main St Suite D Carrboro NC 27510-2072
Phone: (919) 968-6682
Fax: (919) 968-1764
Website:
Map and Directions
Authorized official contact:
Name: Long, Jacob
Phone: (919) 968-6682

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X MHL068017 North Carolina

Profile Details

NPI number 1639232044
LBN Legal business name Club Nova Community, Inc
DBA Doing business as
Authorized official Long, Jacob
Entity Organization
Organization subpart 1 No
Enumeration date Dec 18th, 2006
Last updated Sep 14th, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639232044 NPPES
North Carolina MEDICAID 8301156S

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