Healthcare Provider Details

I. General information

NPI: 1881351377
Provider Name (Legal Business Name): NOBLE TRANSITIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2021
Last Update Date: 11/19/2021
Certification Date: 11/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5615 W 74TH ST
INDIANAPOLIS IN
46278-1753
US

IV. Provider business mailing address

8555 ONE WEST DR APT 311
INDIANAPOLIS IN
46260-5393
US

V. Phone/Fax

Practice location:
  • Phone: 317-966-7012
  • Fax:
Mailing address:
  • Phone: 317-966-7012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TARA LYNN NOBLE
Title or Position: CEO
Credential: MSW
Phone: 317-966-7012