Organization
THE NOVA RESIDENCE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER AGUSTIN (SECRETARY)
(408) 806-7409
Entity
Organization
Contact information
Practice address
527 JEFFERSON ST, TWIN FALLS, ID 83301-3822
(208) 948-0476
Mailing address
148 BLUE LAKES BLVD N # 193, TWIN FALLS, ID 83301-5235
(208) 948-0476
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
—
—
Other
Enumeration date
02/17/2023
Last updated
02/17/2023
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