Tyrek'S Heavenly Angels

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

MHL026770 Issued in NC

Legal business name

TYREK'S HEAVENLY ANGELS

Practice address

1830 Eichelberger Dr
Fayetteville, NC 28303-6257

Phone

(910) 425-6841

Fax

(910) 485-4005

NPI assigned

Feb 13, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Patricia Ann Hill

Title

Ceo

Phone

(910) 425-6841

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780726992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 BENT CREEK DR",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "28348",
            "telephone_number": "910-425-6841",
            "fax_number": "910-485-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 EICHELBERGER DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283036257",
            "telephone_number": "910-425-6841",
            "fax_number": "910-485-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYREK'S HEAVENLY ANGELS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-425-6841",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL026770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603559",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Indira Tyler
• Linda Carol Tyler, FNP-C
• Amber Tyndall, LPN
• Sarah Elizabeth Tyndall, LMBT
• Alicia Marie Tyner, LCSWA
• Xaviana Tyson
• U.S. Healthworks Medical Group of North Carolina, PC
• Daniel Chidi Uba, MD/INTERNAL MEDICINE
• Alexander Uche Jr., MD
• Benjamin Chigbo Udoh, MD

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility 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.