NPIMap

Organization Active NPI

Angel Wings Center of Healing

  • Community/Behavioral Health Agency
  • Idaho Falls, ID
National Provider Identifier
1497962575
Registry record updated Dec 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
LCSW-27373 Issued in ID
Legal business name
ANGEL WINGS CENTER OF HEALING
Practice address
477 Shoup Ave Ste 107B
Idaho Falls, ID 83402-3658
Phone
(208) 522-1914
Fax
(208) 522-1956
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2007

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

Authorized official

Name
Ms. Bobette R Page, LCSW
Title
Owner-Manager
Phone
(208) 757-0330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X LCSW-27373 ID Primary

Addresses

Primary practice location

477 Shoup Ave Ste 107B
Idaho Falls, ID 83402-3658

Mailing address

477 Shoup Ave Ste 107B
Idaho Falls, ID 83402-3658
Phone (208) 522-1914

National Provider Directory

National Provider Directory
Tax ID family
Angel Wings Center of Healing2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

477 Shoup Ave
Ste 107B
Idaho Falls, ID 83402
Phone (208) 522-1914

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199059200000",
    "number": "1497962575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 SHOUP AVE STE 107B",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023658",
            "telephone_number": "208-522-1914",
            "fax_number": "208-522-1956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 SHOUP AVE STE 107B",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023658",
            "telephone_number": "208-522-1914",
            "fax_number": "208-522-1956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL WINGS CENTER OF HEALING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-12-31",
        "status": "A",
        "authorized_official_last_name": "PAGE",
        "authorized_official_first_name": "BOBETTE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER-MANAGER",
        "authorized_official_telephone_number": "208-757-0330",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ID",
            "license": "LCSW-27373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2007; 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.