# ANGELS OF HOPE BEHAVIORAL HEALTH RESIDENTIAL AGENCY

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

## Provider details

- **NPI number:** 1972820371
- **Authorized official:** MRS. LATONYA DENISE JACKSON (OWNER/ADMINISTRATOR)
- **Authorized official phone:** (480) 628-4614

## Contact information

- **Practice address:** 483 W GASCON RD, QUEEN CREEK, AZ 85143-5467
- **Practice address phone:** (480) 628-4614
- **Practice address fax:** (480) 699-9761
- **Mailing address:** 483 W GASCON RD, QUEEN CREEK, AZ 85143-5467
- **Mailing address phone:** (480) 628-4614
- **Mailing address fax:** (480) 699-9761

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | BH3556 | AZ | Yes |

## Other

- **Enumeration date:** 04/23/2010
- **Last updated:** 09/17/2010