MEDICARE: NOAHS ARK ADVOCACY AND REFERRAL SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency	36496	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558435115
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOAHS ARK ADVOCACY AND REFERRAL SERVICES

Provider Business Mailing Address
First Line	:	9010 SAINT JULIEN CT
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-3538
Country	:	US
Telephone Number	:	210-682-6530
Fax Number	:	210-682-3530

Provider Business Practice Location Address
First Line	:	9010 SAINT JULIEN CT
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-3538
Country	:	US
Telephone Number	:	210-682-6530
Fax Number	:	210-682-3530

Authorized Official
Title or Position	:	OWNER
Name	:	MS. VERONICA CRYSTAL HOLGUIN
Credential	:	LMSW
Telephone Number	:	210-682-6530

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	06/24/2008

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9010 SAINT JULIEN CT
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