Organization
NEW NOVIS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES PRUITT (CEO)
(404) 629-7378
Entity
Organization
Contact information
Practice address
4061 N HENRY BLVD SUITE E, STOCKBRIDGE, GA 30281
(404) 629-7378
Mailing address
4061 N HENRY BLVD SUITE E, STOCKBRIDGE, GA 30281
(404) 629-7378
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
174200000X
Meals Provider
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
06/17/2024
Last updated
06/17/2024
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