Organization
ANGEL WING RESIDENTIAL CARE HOME
Active
Other names
Residential Care Home
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE THOMAS WALLS (OWNER)
(334) 349-6916
Entity
Organization
Contact information
Practice address
803 FLOYD AVE, DEMOPOLIS, AL 36732-3157
(334) 349-6916
Mailing address
803 FLOYD AVE, DEMOPOLIS, AL 36732-3157
(334) 349-6916
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/08/2017
Last updated
02/08/2017
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