Angel Manor PCS LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

10343 Issued in LA

Legal business name

ANGEL MANOR PCS LLC

Practice address

708 S Washington St
Lafayette, LA 70501-6810

Phone

(337) 232-7761

Fax

(337) 232-7762

NPI assigned

Nov 28, 2006

Last updated

Aug 22, 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

Mr. John Samuel Ford

Title

Owner

Phone

(337) 232-7761

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Angel Manor2 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.

• Angel Manor

  • Developmentally Disabled Services Day Training Agency
  • Lafayette, LA
  • NPI 1194990879
  NPD tax ID

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942376108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 S WASHINGTON ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705016810",
            "telephone_number": "337-232-7761",
            "fax_number": "337-232-7762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 S WASHINGTON ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705016810",
            "telephone_number": "337-232-7761",
            "fax_number": "337-232-7762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL MANOR PCS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-232-7761",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "LA",
            "license": "10343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1178179",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Angel Manor, LLC.
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• Precious Renee Angelle

• Developmentally Disabled Services Day Training Agency in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Developmentally Disabled Services Day Training Agency in Louisiana

• 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.