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Organization
ANGEL INTERVENTION SERVICES LLC
Active
Organization
ANGEL INTERVENTION SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY LYN CONKLIN CDCA II, CDAC, CIP (CEO/OWNER)
(918) 500-2570
Entity
Organization
Contact information
Practice address
123 S WASHINGTON ST, VAN WERT, OH 45891-1707
(419) 771-1050
Mailing address
123 S WASHINGTON ST, VAN WERT, OH 45891-1707
(800) 430-2995
(419) 771-1051
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NULL
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
251B00000X
Case Management Agency
—
NULL
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
NULL
324500000X
Substance Abuse Rehabilitation Facility
—
NULL
Other
Enumeration date
08/08/2017
Last updated
07/12/2023
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