NOVA VITAL IOP LLC is a rehabilitation and substance use disorder clinic center in Shreveport, LA. NOVA VITAL IOP LLC NPI is 1477242196. The provider is registered as an organization entity type.
The provider's business location address is:
850 MARGARET PL
SHREVEPORT, LA
ZIP 71101-521
Phone: (318) 268-6101
The provider's authorized official is Mallory Macisaac .
The authorized official title is Controller and has the following contact phone number (318) 268-6101.
The CLIA number assigned to this NPI record is 19D2287261 - other - op counseling cntr with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 5/8/2023 and was last updated on 4/5/2024.