Organization
CARRABAUN
Active
Parent organization
HOLY ANGELS INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOLY ANGELS INC.
Authorized official
SHANNON PRINCE (VP OF CLINICAL SERVICES)
(704) 829-4411
Entity
Organization
Contact information
Practice address
303 MCAULEY CIRCLE, BELMONT, NC 28012-0710
(704) 829-4418
Mailing address
PO BOX 710, BELMONT, NC 28012-0710
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
311ZA0620X
Adult Care Home Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
MHL-036-111
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619310851
STATE FUNDS THROUGH PARTNERS MCO
NC
05
—
7802692
—
NC
05
—
7803423
—
NC
Enumeration date
06/12/2009
Last updated
08/30/2017
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