Provider Demographics
NPI:1669951810
Name:NOBLE HEARTS HOME CARE LLC
Entity type:Organization
Organization Name:NOBLE HEARTS HOME CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHANEL
Authorized Official - Middle Name:CHIQUITA
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-235-4044
Mailing Address - Street 1:6232 RIDGE AVE # 1
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-2631
Mailing Address - Country:US
Mailing Address - Phone:267-235-4044
Mailing Address - Fax:
Practice Address - Street 1:6232 RIDGE AVE # 1
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-2631
Practice Address - Country:US
Practice Address - Phone:267-235-4044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRUST MEDICAL TRANSPORTATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-08
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA38053601374U00000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3416L0300XTransportation ServicesAmbulanceLand TransportGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA38053601OtherLICENSE #