# LITTLE ANGELS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** N/A
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336408632
- **Authorized official:** MRS. LISA RENEA CRUZ RN (OWNER)
- **Authorized official phone:** (208) 313-0711

## Contact information

- **Practice address:** 1680 WOODRUFF PARK, IDAHO FALLS, ID 83401-3330
- **Practice address phone:** (208) 313-0711
- **Mailing address:** 1680 WOODRUFF PARK, IDAHO FALLS, ID 83401-3330
- **Mailing address phone:** (208) 313-0711

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0800X | Psychiatry Physician | M-9188 | ID | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | NULL | Yes |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | — | Yes |
| 363A00000X | Physician Assistant | PA-334 | ID | — |

## Other

- **Enumeration date:** 05/08/2012
- **Last updated:** 02/01/2013