Provider Demographics
NPI:1770176968
Name:NOBLE CARE HOMEHEALTH
Entity type:Organization
Organization Name:NOBLE CARE HOMEHEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ISATU
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRIE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:240-444-3942
Mailing Address - Street 1:6081 64TH AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-2978
Mailing Address - Country:US
Mailing Address - Phone:240-444-3942
Mailing Address - Fax:
Practice Address - Street 1:6081 64TH AVE
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-2978
Practice Address - Country:US
Practice Address - Phone:240-444-3942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1366981029Medicaid
MD55001820Medicaid