Angels Haven, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

132136 Issued in TX

Legal business name

ANGELS HAVEN, LLC

Practice address

2724 Calico Rock Dr
Fort Worth, TX 76131-2034

Phone

(817) 262-0333

Fax

(817) 386-2929

NPI assigned

Jun 16, 2011

Last updated

Jun 16, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Trang T Carr

Title

Managing Member / President

Phone

(817) 262-0333

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308182400000",
    "number": "1043505175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4956 OBRIEN WAY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762446142",
            "telephone_number": "817-262-0333",
            "fax_number": "817-386-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 CALICO ROCK DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761312034",
            "telephone_number": "817-262-0333",
            "fax_number": "817-386-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELS HAVEN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-16",
        "last_updated": "2011-06-16",
        "status": "A",
        "authorized_official_last_name": "CARR",
        "authorized_official_first_name": "TRANG",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "MANAGING MEMBER / PRESIDENT",
        "authorized_official_telephone_number": "817-262-0333",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "132136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.