# ANGELIC LIFE CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962915645
- **Authorized official:** DIONNA BROCK RICHARDSON (CEO)
- **Authorized official phone:** (713) 429-2767

## Contact information

- **Practice address:** 14515 BRIARHILLS PKWY STE 208A, HOUSTON, TX 77077-1034
- **Practice address phone:** (713) 429-2767
- **Practice address fax:** (888) 433-4788
- **Mailing address:** 3536 HIGHWAY 6 \# 185, SUGAR LAND, TX 77478-4401
- **Mailing address phone:** (713) 429-2767
- **Mailing address fax:** (888) 433-4788

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | — | NULL | — |
| 385HR2060X | Child Intellectual and/or Developmental Disabilities Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 11/16/2017
- **Last updated:** 04/15/2022