Organization Name: | MARY'S ANGELS INDEPENDENT LIVING FOR YOUNG WOMEN |
NPI Number: | 1144639881 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JUANTIA GREEN (PRESIDENT/CEO) |
Mailing Address: | 29 Sunflower Dr Cades |
State: | SC US |
Postal Code: | 295183312 |
Phone Number: | 8433825285 |
Fax Number: | 8433827280 |
NPI Enumeration Date: | 08/06/2014 |
NPI Last Update Date: | 08/06/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |