Angel Wings Assisted Living, Inc

Organization Active NPI Assisted Living Facility · Vernon, AZ

NPI 1043592496 · NPPES record last updated Mar 18, 2012

Key facts

NPI
1043592496
Entity type
Organization (NPI type 2)
Primary specialty
Assisted Living Facility 310400000X
Legal business name
ANGEL WINGS ASSISTED LIVING, INC
Practice address
86 Acr 3148
Vernon, AZ 85940
Phone
(928) 242-5517
Fax
(877) 581-4791
NPI assigned
Sep 12, 2011
Organization subpart
No

Authorized official

Name
Audrey Lee Felix
Title
Owner/Manager
Phone
(928) 242-5517

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AZ Yes

Addresses

Primary practice location

86 Acr 3148
Vernon, AZ 85940

Mailing address

PO Box 339
Vernon, AZ 85940-0339
Phone (928) 242-5517

Other identifiers

IdentifierTypeStateIssuer
657171MedicaidAZ
AL8533HOtherAZDHS

Other providers in Vernon, AZ

All providers in Vernon, AZ · Assisted Living Facility in Arizona

Sources for this page

Verify at the official NPI Registry.