Angelic Community & Family Services

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

ANGELIC COMMUNITY & FAMILY SERVICES

Practice address

5601 Executive Center Dr
Suite 220
Charlotte, NC 28212-8863

Phone

(704) 532-6369

Fax

(866) 293-6371

NPI assigned

Nov 23, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Eric Bernard Mitchell Sr.

Title

Clinical Director

Phone

(866) 391-6369

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Angelic Community and Family Services2 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.

• Angelic Community &and Family Services

  • Preferred Provider Organization
  • Charlotte, NC
  • NPI 1134328636
  NPD tax ID

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

{
    "created_epoch": "1164240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710052683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 EXECUTIVE CENTER DR",
            "address_2": "SUITE 220",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282128863",
            "telephone_number": "704-532-6369",
            "fax_number": "866-293-6371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 EXECUTIVE CENTER DR",
            "address_2": "SUITE 220",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282128863",
            "telephone_number": "704-532-6369",
            "fax_number": "866-293-6371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELIC COMMUNITY & FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "BERNARD",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "866-391-6369",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408218",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angel Star Home Health, Inc
• Angel Star Home Health, Inc.
• Angel Star Home Health, Inc.
• Angela Chop Psychological Services
• Angelas Helping Handz Inc.
• Angelic Community &and Family Services
• Angelic Health and Hope LLC
• Angelic Home Care Agency LLC
• Angelic Host Enterprise Inc.
• Angelic Host Helping Hands, LLC

• Preferred Provider Organization in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Preferred Provider Organization in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.