Nova Vital Iop LLC
NPI #1477242196 in Shreveport, Louisiana
Provider Information
- NPI Number
- 1477242196
- Entity Type
- Organization
- Organization Name
- Nova Vital Iop LLC
- Primary Specialty
- Clinic/Center - Rehabilitation, Substance Use Disorder
- Enumeration Date
- May 8, 2023
- Last Updated
- Apr 5, 2024
Practice Location
- Address
- 850 MARGARET PL
- City
- Shreveport
- State
- Louisiana
- ZIP Code
- 71101-4521
- Phone
- (318) 268-6101
Authorized Official
- Name
- MRS. MALLORY MACISAAC
- Title
- CONTROLLER
- Phone
- (318) 268-6101
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder |
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