Organization
HEAVELY ANGELS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE TIMPSON (OWNER)
(336) 432-1861
Entity
Organization
Contact information
Practice address
3725 ANITA LN, GREENSBORO, NC 27405-9412
(336) 617-3789
Mailing address
3725 ANITA LN, GREENSBORO, NC 27405-9412
(336) 617-3789
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-041-988
NC
Other
Enumeration date
02/16/2011
Last updated
02/16/2011
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