Organization
FALLEN ANGELS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIAH RAE BROWN NP (CEO)
(505) 389-8100
Entity
Organization
Contact information
Practice address
5104 SAN ADAN AVE NW, ALBUQUERQUE, NM 87120-1834
(626) 940-4511
Mailing address
5104 SAN ADAN AVE NW, ALBUQUERQUE, NM 87120-1834
(626) 940-4511
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
12/13/2022
Last updated
12/16/2022
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