Provider Demographics
NPI:1922372390
Name:NOBLE CARE CORP.
Entity Type:Organization
Organization Name:NOBLE CARE CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-331-3642
Mailing Address - Street 1:140 S CAMINO SECO
Mailing Address - Street 2:SUITE 305
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-4484
Mailing Address - Country:US
Mailing Address - Phone:520-398-5675
Mailing Address - Fax:520-398-5887
Practice Address - Street 1:3711 S CINDY LN
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85730-4444
Practice Address - Country:US
Practice Address - Phone:520-344-7260
Practice Address - Fax:520-344-7260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-02
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ983553Medicaid