Organization
ANGELO'S CARE HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY LOCKLEAR (DIRECTOR)
(910) 521-1895
Entity
Organization
Contact information
Practice address
707 UNION CHAPEL RD, PEMBROKE, NC 28372-8689
(910) 521-1895
(910) 521-7220
Mailing address
10091 US HIGHWAY 74 W, MAXTON, NC 28364-8936
(910) 521-1895
(910) 521-7220
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
HC4768
NC
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
MHL-078-304
NC
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
HC4768
NC
253Z00000X
In Home Supportive Care Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-078-138
NC
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
MHL-078-275
NC
320700000X
Physical Disabilities Residential Treatment Facility
MHL-078-138
NC
385H00000X
Respite Care
MHL-078-138
NC
385H00000X
Respite Care
MHL-078-275
NC
Other
Enumeration date
12/21/2006
Last updated
08/15/2019
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