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Organization

ANGELS, LLC

Active
Other names
Angels, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
KATHLEEN DESHAZO- JACKSON MSW, LCSW (CEO)
(804) 901-0681
Entity
Organization

Contact information

Practice address
5941 TUSKWILLOW DR, CHESTERFIELD, VA 23832-8154
(804) 901-0681
Mailing address
PO BOX 34255, NORTH CHESTERFIELD, VA 23234-0255
(804) 901-0681
(804) 901-0681

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Other

Enumeration date
04/11/2025
Last updated
05/19/2025
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