Healthcare Provider Details

I. General information

NPI: 1952437493
Provider Name (Legal Business Name): NOBLES GROUP HOMES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 01/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 S SHELTON BEACH RD
MOBILE AL
36613-3415
US

IV. Provider business mailing address

6902 PROVIDENCE ESTATE DR S
MOBILE AL
36695-4612
US

V. Phone/Fax

Practice location:
  • Phone: 251-438-1340
  • Fax: 251-438-2052
Mailing address:
  • Phone: 251-438-1340
  • Fax: 251-438-2052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number000316800
License Number StateAL

VIII. Authorized Official

Name: MR. DEVIN DEMETRIUS NOBLES SR.
Title or Position: PRESIDENT
Credential:
Phone: 251-438-1340