Provider Demographics
NPI:1124150917
Name:NOBLE HEART SERVICES
Entity type:Organization
Organization Name:NOBLE HEART SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NKONYE
Authorized Official - Middle Name:ADA
Authorized Official - Last Name:EZEOBAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-856-0406
Mailing Address - Street 1:16610 CRENSHAW BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-2108
Mailing Address - Country:US
Mailing Address - Phone:310-856-0406
Mailing Address - Fax:310-856-0408
Practice Address - Street 1:16610 CRENSHAW BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90504-2108
Practice Address - Country:US
Practice Address - Phone:310-856-0406
Practice Address - Fax:310-856-0408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7101261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder