Organization
NOVA-IC, INC.
Active
Other names
Holly street Home
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY PRIDGEN CPA (CFO)
(919) 734-8803
Entity
Organization
Contact information
Practice address
1509 E HOLLY ST, GOLDSBORO, NC 27530-3033
(919) 734-8803
(919) 735-6825
Mailing address
PO BOX 11077, GOLDSBORO, NC 27532-1077
(919) 734-8803
(919) 735-6825
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
MHL-096-114
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3406312
—
NC
Enumeration date
02/18/2009
Last updated
10/08/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us