# NOVA CARE CENTER LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NOVA CARE CENTER LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1174240204
- **Legal business name:** NOVA CARE CENTER LLC
- **Authorized official:** AYAN ABDI MAHAMUD (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (612) 964-0142

## Contact information

- **Practice address:** 8673 COLUMBINE RD, EDEN PRAIRIE, MN 55344-7668
- **Practice address phone:** (612) 964-0142
- **Mailing address:** 8673 COLUMBINE RD, EDEN PRAIRIE, MN 55344-7668
- **Mailing address phone:** (612) 964-0142

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/19/2022
- **Last updated:** 04/29/2023