Organization Name: | FORGOTTEN ANGELS |
NPI Number: | 1205037066 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JODI WEST (PROGRAM DIRECTOR) |
Mailing Address: | 7918 Broadway St Ste 104 Pearland |
State: | TX US |
Postal Code: | 775817758 |
Phone Number: | 2814126435 |
Fax Number: | 2814125060 |
NPI Enumeration Date: | 05/30/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320900000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |