Heavenly Angels Group Home, Inc

NPI 1457591356 - Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities - 320600000X

NPI Details
NPI 1457591356
Enumeration Date 03/05/2009
Last Updated 03/05/2009
Entity Type Healthcare Provider
Active Over 7 years ago
Authorized Information
Name ANTOINETTA DEMTRIA ANTOINETTA
Position ONWER/ DIRECTOR
Phone (336) 358-2137
Fax (336) 358-2136
Practice Location
3725 ANITA LN
GREENSBORO NC, 27405-9412, US
Phone (336) 358-2137
Fax (336) 358-2136
Business Location
503 W MCGEE ST
GREENSBORO NC, 27401-2702, US
Phone (336) 230-0808
Fax (336) 230-0842
Toxanomy
Taxonomy Code 320600000X
License State North Carolina
License Number MHL-041-895
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According to our database, Heavenly Angels Group Home, Inc NPI is 1457591356, taxonomy code is 320600000X and license number is MHL-041-895, license state is located at North Carolina. Heavenly Angels Group Home, Inc physically located at 3725 Anita Ln, Greensboro NC, 27405-9412. NPI Number 1033115704 has the healthcare provider type.

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1457591356 NPI number is provided on an as is basis without warranty of any kind. 1457591356 is maintained by the National Plan & Provider Enumeration System. The contents of Heavenly Angels Group Home, Inc are for informational purposes only.