Organization
ANGELIC PLACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EMIGDUS NKEM (RESIDENTIAL DIRECTOR)
(571) 494-7066
Entity
Organization
Contact information
Practice address
8108 CHERRY TREE DR, FREDERICKSBURG, VA 22407-7344
(571) 494-7066
(571) 494-7066
Mailing address
5500 SILVER MAPLE LN, FREDERICKSBURG, VA 22407-9357
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/26/2017
Last updated
10/26/2017
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