Angelic Care Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

ANGELIC CARE INC.

Practice address

14604 Goshawk Dr
Pflugerville, TX 78660-4478

Phone

(512) 786-0327

NPI assigned

Nov 25, 2019

Last updated

Oct 5, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ebenezer Bamidele Ayodele, CEO

Title

Chief Executive Officer

Phone

(512) 786-0327

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601856000000",
    "number": "1467098327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3317",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786913317",
            "telephone_number": "512-786-0327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14604 GOSHAWK DR",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786604478",
            "telephone_number": "512-786-0327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELIC CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-25",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A",
        "authorized_official_last_name": "AYODELE",
        "authorized_official_first_name": "EBENEZER",
        "authorized_official_middle_name": "BAMIDELE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "512-786-0327",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Pflugerville, TX
• Providers in Pflugerville, TX by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; 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.