Organization
ANGEL CARE ENTERPRISES
Active
Other names
COLE HOME
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPHINE WHITE (OWNER)
(909) 863-1221
Entity
Organization
Contact information
Practice address
6996 COLE AVE, HIGHLAND, CA 92346-3134
(909) 863-4941
(909) 863-4941
Mailing address
6996 COLE AVE, HIGHLAND, CA 92346-3134
(909) 863-4941
(909) 863-4941
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC60969G
—
CA
Enumeration date
02/27/2007
Last updated
08/22/2020
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