Organization
ANOVA'S SKILLED NURSING AND HOME HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMIKO DANYELLE MOORE RN (BUSINESS OWNER/EMPLOYEE)
(314) 445-7045
Entity
Organization
Contact information
Practice address
301 E LAKE DR, FAYETTEVILLE, GA 30214-3207
(314) 445-7045
Mailing address
301 E LAKE DR, FAYETTEVILLE, GA 30214-3207
(314) 445-7045
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
—
174200000X
Meals Provider
—
—
251E00000X
Home Health Agency
—
—
251F00000X
Home Infusion Agency
—
—
251J00000X
Nursing Care Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
314000000X
Skilled Nursing Facility
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
01/16/2023
Last updated
01/16/2023
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