Nova Family Outreach LLC
Community Based Residential Treatment Facility, Mental Illness in Winston Salem, NC. Organization (NPI-2).
Details
- NPI
- 1962228486
- Entity type
- Organization (NPI-2)
- Legal business name
- Nova Family Outreach LLC
- Organization subpart
- No
- Enumeration date
- Nov 30, 2024
- Certification date
- Dec 2, 2024
- Last updated
- Dec 2, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | – | – | Yes |
| 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | – | – |
Practice location
3008 White Meadow LnWinston Salem, NC 27107-5541
Phone 704-968-2492
Mailing address
Po Box 668352Charlotte, NC 28266-8352
Phone 704-968-2492
Authorized official
Deanna Velazquez
Owner, Clinical Director
7049682492
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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