Angel Family Care, LLC
Organization Active NPI Mental Illness Community Based Residential Treatment Facility · San Tan Valley, AZ
NPI 1104475763 · NPPES record last updated Jun 21, 2021
Key facts
- NPI
- 1104475763
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Illness Community Based Residential Treatment Facility 320800000X
- Legal business name
- ANGEL FAMILY CARE, LLC
- Practice address
- 28370 N Gold LN
San Tan Valley, AZ 85143-6059 - Phone
- (480) 720-3393
- NPI assigned
- Sep 6, 2019
- Organization subpart
- No
Authorized official
- Name
- Ms. Chantelle Ezinne Oguadimma, LAC
- Title
- Chief Executive Officer
- Phone
- (480) 720-3393
Practitioners 1
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | |||
| Mental Health Counselor |
101YM0800X | |||
| Community/Behavioral Health Agency | 251S00000X | |||
| Mental Illness Community Based Residential Treatment Facility | 320800000X | Yes |
Addresses
Primary practice location
28370 N Gold LN
San Tan Valley, AZ 85143-6059
Mailing address
28370 N Gold LN
San Tan Valley, AZ 85143-6059
Phone (480) 720-3393
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All providers in San Tan Valley, AZ · Mental Illness Community Based Residential Treatment Facility in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.