Organization Name: | ANGELO'S CARE HOME, INC |
NPI Number: | 1790981512 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JUDY CINDY LOCKLEAR (ADMINISTRATOR) |
Mailing Address: | 10091 Us Highway 74 W Maxton |
State: | NC US |
Postal Code: | 283648936 |
Phone Number: | 9105211895 |
Fax Number: | 9105217220 |
NPI Enumeration Date: | 06/27/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 5223 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |