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Organization
HOLY ANGELS SERVICES INC.
Active
Organization
HOLY ANGELS SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANNON WORTMAN PRINCE B.S. (VICE PRESIDENT OF CLINICAL SERVICES)
(704) 829-4418
Entity
Organization
Contact information
Practice address
6600 E WILKINSON BLVD, BELMONT, NC 28012-4707
(704) 829-4418
Mailing address
6600 E WILKINSON BLVD, BELMONT, NC 28012-4707
(704) 829-4418
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
MHL-036-012
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7211943
—
NC
Enumeration date
05/09/2008
Last updated
08/31/2017
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