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Organization
NOVA CLINIC LLC
Active
Organization
NOVA CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOHAIL DAULAT (ADMINISTRATOR)
(623) 986-5609
Entity
Organization
Contact information
Practice address
6049 E GRANT RD, TUCSON, AZ 85712-2317
(623) 986-5609
Mailing address
1717 W NORTHERN AVE STE 204D, PHOENIX, AZ 85021-5471
(480) 499-3571
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
106S00000X
Behavior Technician
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
04/27/2023
Last updated
04/27/2023
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