Provider Demographics
NPI:1588485882
Name:NOELLE HOSPICE, LLC
Entity type:Organization
Organization Name:NOELLE HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:CORPUZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:909-900-7774
Mailing Address - Street 1:574 FIDDLEHEAD AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-4665
Mailing Address - Country:US
Mailing Address - Phone:909-900-7774
Mailing Address - Fax:
Practice Address - Street 1:9728 GILESPIE ST # 18
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89183-7611
Practice Address - Country:US
Practice Address - Phone:909-900-7774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based