Angelic Place LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

ANGELIC PLACE LLC

Practice address

8108 Cherry Tree Dr
Fredericksburg, VA 22407-7344

Phone

(571) 494-7066

Fax

(571) 494-7066

NPI assigned

Oct 26, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Emigdus Nkem

Title

Residential Director

Phone

(571) 494-7066

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508976000000",
    "number": "1083126346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 SILVER MAPLE LN",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224079357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8108 CHERRY TREE DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224077344",
            "telephone_number": "571-494-7066",
            "fax_number": "571-494-7066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELIC PLACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-26",
        "last_updated": "2017-10-26",
        "status": "A",
        "authorized_official_last_name": "NKEM",
        "authorized_official_first_name": "EMIGDUS",
        "authorized_official_title_or_position": "RESIDENTIAL DIRECTOR",
        "authorized_official_telephone_number": "571-494-7066",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; 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.