Provider Demographics
NPI:1053727644
Name:NOBLE PERSONAL HOME CARE, LLC
Entity type:Organization
Organization Name:NOBLE PERSONAL HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-740-9141
Mailing Address - Street 1:2150 TRAWOOD DR STE B260
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-3332
Mailing Address - Country:US
Mailing Address - Phone:915-740-9141
Mailing Address - Fax:915-990-2229
Practice Address - Street 1:2150 TRAWOOD DR STE B260
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-3332
Practice Address - Country:US
Practice Address - Phone:915-740-9141
Practice Address - Fax:915-990-2229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-03
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251C00000X, 3747P1801X
TX253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty