NPIMap

Organization Active NPI

Angelic Care Group LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Katy, TX
National Provider Identifier
1396204160
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
ANGELIC CARE GROUP LLC
Practice address
5106 Smokey River Dr
Katy, TX 77449-6017
Phone
(281) 746-1292
NPI assigned
Mar 19, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Authorized official

Name
Roland Deddeh, MBANPI 1508303850
Title
President/Owner
Phone
(281) 746-1292

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

5106 Smokey River Dr
Katy, TX 77449-6017

Mailing address

5106 Smokey River Dr
Katy, TX 77449-6017
Phone (281) 746-1292

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL deddehroland37@gmail.com

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552953600000",
    "number": "1396204160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5106 SMOKEY RIVER DR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774496017",
            "telephone_number": "281-746-1292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5106 SMOKEY RIVER DR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774496017",
            "telephone_number": "281-746-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELIC CARE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-19",
        "last_updated": "2019-03-19",
        "status": "A",
        "authorized_official_last_name": "DEDDEH",
        "authorized_official_first_name": "ROLAND",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "281-746-1292",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "deddehroland37@gmail.com",
            "affiliation": "N",
            "address_1": "5106 Smokey River Dr",
            "city": "Katy",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774496017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; 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.