Organization
DIVINE ANGELS BEHAVIORAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHARISSE MARIE NEAL (OWNER/PROVIDER)
(702) 684-3457
Entity
Organization
Contact information
Practice address
304 LANCE AVE, N LAS VEGAS, NV 89030-3844
(702) 684-3457
Mailing address
304 LANCE AVE, N LAS VEGAS, NV 89030-3844
(702) 684-3457
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/23/2015
Last updated
07/23/2015
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