Healthcare Provider Details

I. General information

NPI: 1558792283
Provider Name (Legal Business Name): NOBLEQUEST HEALTH FOUNDATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2013
Last Update Date: 07/13/2023
Certification Date: 07/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14435 HAMLIN ST STE 108
VAN NUYS CA
91401-6205
US

IV. Provider business mailing address

11024 BALBOA BLVD 504
GRANADA HILLS CA
91344
US

V. Phone/Fax

Practice location:
  • Phone: 818-997-7117
  • Fax: 888-833-2881
Mailing address:
  • Phone: 818-363-3000
  • Fax: 888-833-2881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: AILENE RIVERA
Title or Position: FOUNDER
Credential: RPT
Phone: 818-363-3066