The Nova Residence Inc

Primary specialty

Lodging ProviderTaxonomy code 177F00000X

Legal business name

THE NOVA RESIDENCE INC

Practice address

527 Jefferson St
Twin Falls, ID 83301-3822

Phone

(208) 948-0476

NPI assigned

Feb 17, 2023

Last updated

Feb 17, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Jennifer Agustin

Title

Secretary

Phone

(408) 806-7409

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1676592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676592000000",
    "number": "1871291062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 BLUE LAKES BLVD N # 193",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015235",
            "telephone_number": "208-948-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 JEFFERSON ST",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013822",
            "telephone_number": "208-948-0476"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "440 Martin St",
            "address_purpose": "LOCATION",
            "city": "Twin Falls",
            "state": "ID",
            "postal_code": "833014546",
            "country_code": "US",
            "telephone_number": "208-948-0476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE NOVA RESIDENCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-17",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A",
        "authorized_official_last_name": "AGUSTIN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "408-806-7409",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lodging Provider in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.