Organization
ANGEL WINGS ASSISTED LIVING, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDREY LEE FELIX (OWNER/MANAGER)
(928) 242-5517
Entity
Organization
Contact information
Practice address
86 ACR 3148, VERNON, AZ 85940
(928) 242-5517
(877) 581-4791
Mailing address
PO BOX 339, VERNON, AZ 85940-0339
(928) 242-5517
(877) 581-4791
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
657171
—
AZ
01
—
AL8533H
DHS
AZ
Enumeration date
09/12/2011
Last updated
03/18/2012
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