Provider Demographics
NPI:1669240610
Name:NOAH COMMUNITY SERVICE ASSOCIATES INC
Entity type:Organization
Organization Name:NOAH COMMUNITY SERVICE ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NOUSHABA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-331-6291
Mailing Address - Street 1:7522 N HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-4400
Mailing Address - Country:US
Mailing Address - Phone:414-331-6291
Mailing Address - Fax:
Practice Address - Street 1:7522 N HARLEM AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-4400
Practice Address - Country:US
Practice Address - Phone:414-331-6291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health