Provider Demographics
NPI:1992858591
Name:NOIA RESIDENTIAL SERVICES INC
Entity Type:Organization
Organization Name:NOIA RESIDENTIAL SERVICES INC
Other - Org Name:CASA FLAMENGOS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:LUCIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:NOIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-485-5555
Mailing Address - Street 1:606 E BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93701-1527
Mailing Address - Country:US
Mailing Address - Phone:559-485-5555
Mailing Address - Fax:559-485-8919
Practice Address - Street 1:1580 E ALMENDRA
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710
Practice Address - Country:US
Practice Address - Phone:559-449-9226
Practice Address - Fax:559-449-9226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
315P00000X
CA040000234320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALTC60213FMedicaid