Provider Demographics
NPI:1013643816
Name:NOBLE HEARTS FOUNDATION
Entity Type:Organization
Organization Name:NOBLE HEARTS FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-813-3027
Mailing Address - Street 1:1350 W 5TH AVE STE 10B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2907
Mailing Address - Country:US
Mailing Address - Phone:614-813-3027
Mailing Address - Fax:
Practice Address - Street 1:1350 W 5TH AVE STE 10B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-2907
Practice Address - Country:US
Practice Address - Phone:614-813-3027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH48554524255Medicaid