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

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101YA0400X
Mental Health Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
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

Other providers in San Tan Valley, AZ

All providers in San Tan Valley, AZ · Mental Illness Community Based Residential Treatment Facility in Arizona

Sources for this page

Verify at the official NPI Registry.