Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nova Ic, Inc

Organization Intellectual Disabilities Intermediate Care Facility · NPI 1447499330

Nova Ic, Inc is an Intellectual Disabilities Intermediate Care Facility in LA Grange, North Carolina. Licensed in North Carolina. Registered with an NPI since 2009.

Licensed in
NC
In the registry since
2009
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

405 W Washington St
LA Grange, NC 28551-1623
Phone: (919) 734-8803
Fax: (919) 735-6825
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual Disabilities Intermediate Care Facility (primary) Taxonomy 315P00000X · Licence MHL-054-019 (NC)

Record details

NPI number1447499330
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tracey Pridgen — Cfo · (919) 734-8803
Other names Lagrange Home; Lagrange Home
NPI enumeratedFebruary 17, 2009
Last updated in NPPESOctober 8, 2025
Certification dateOctober 8, 2025
Mailing addressPo Box 11077, Goldsboro, NC 27532-1077

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