Angel's Group Home, LLC

Primary specialty

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

Legal business name

ANGEL'S GROUP HOME, LLC

Practice address

10590 Cleveland Rd
Garner, NC 27529-8187

Phone

(919) 963-9167

Fax

(919) 963-9168

NPI assigned

Jun 28, 2010

Last updated

Jun 28, 2010By 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

Ms. Valarie Constance McCullersNPI 1437323763

Title

Ceo

Phone

(919) 963-9167

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Valarie C McCullers, CEO

  • Home Health Aide
  • Garner, NC
  • NPI 1437323763
  NPD (past) Authorized official

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277683200000",
    "number": "1639480346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10590 CLEVELAND ROAD",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "27529",
            "telephone_number": "919-963-9167",
            "fax_number": "919-963-9168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10590 CLEVELAND RD",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275298187",
            "telephone_number": "919-963-9167",
            "fax_number": "919-963-9168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL'S GROUP HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-28",
        "last_updated": "2010-06-28",
        "status": "A",
        "authorized_official_last_name": "MCCULLERS",
        "authorized_official_first_name": "VALARIE",
        "authorized_official_middle_name": "CONSTANCE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-963-9167",
        "authorized_official_name_prefix": "Ms."
    },
    "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": []
}

• Paula Amezquita, LCMHCA, LCASA
• Michael Todd Amick, REGISTERED DIETITIAN
• Elizabeth Anderson
• Shakeria Anderson
• Erica Andrews
• Angela S Wingate DDS
• Anna-Kate Miller LCSW PLLC
• Donald Anthony, LAT, ATC
• Angel Archer, LCSWA
• Elizabeth Armenteros

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Garner, NC
• Providers in Garner, NC by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2010; 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.