Healthcare Provider Details

I. General information

NPI: 1558435115
Provider Name (Legal Business Name): NOAHS ARK ADVOCACY AND REFERRAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 06/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9010 SAINT JULIEN CT
SAN ANTONIO TX
78240-3538
US

IV. Provider business mailing address

9010 SAINT JULIEN CT
SAN ANTONIO TX
78240-3538
US

V. Phone/Fax

Practice location:
  • Phone: 210-682-6530
  • Fax: 210-682-3530
Mailing address:
  • Phone: 210-682-6530
  • Fax: 210-682-3530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number36496
License Number StateTX

VIII. Authorized Official

Name: MS. VERONICA CRYSTAL HOLGUIN
Title or Position: OWNER
Credential: LMSW
Phone: 210-682-6530