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Organization
NOVA CARE MULTICLINIC LLC
Active
Organization
NOVA CARE MULTICLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIASHEN MOODLEY NONE (ADMINISTRATOR)
(623) 703-9840
Entity
Organization
Contact information
Practice address
1717 W NORTHERN AVE STE 200, PHOENIX, AZ 85021-5478
(623) 703-9840
Mailing address
1717 W NORTHERN AVE STE 204D, PHOENIX, AZ 85021-5471
(623) 703-9840
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
174400000X
Specialist
—
—
202D00000X
Integrative Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207QA0000X
Adolescent Medicine (Family Medicine) Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
207QA0505X
Adult Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208D00000X
General Practice Physician
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
405300000X
Prevention Professional
—
—
Other
Enumeration date
04/27/2023
Last updated
04/27/2023
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