Organization
ANGELWINGS COORDINATED CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON L BEATY (OWNER)
(505) 539-2227
Entity
Organization
Contact information
Practice address
HC 61, BOX 416 QUAIL DRIVE, GLENWOOD, NM 88039
(505) 539-2227
(505) 539-2225
Mailing address
HC 61, BOX 416 QUAIL DRIVE, GLENWOOD, NM 88039
(505) 539-2227
(505) 539-2225
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42284091
—
NM
05
—
53908325
—
NM
Enumeration date
01/11/2007
Last updated
08/22/2020
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