Organization
LIFECHOICES
Active
Parent organization
HOLY ANGELS INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOLY ANGELS INC.
Authorized official
REGINA MOODY (PRESIDENT/CEO)
(704) 825-4161
Entity
Organization
Contact information
Practice address
6600 W WILKINSON BLVD, BELMONT, NC 28012-2796
(704) 825-4161
Mailing address
225B MARKET ST, CRAMERTON, NC 28032-1146
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
036-310
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619310851
STATE FUNDED
NC
05
—
3408854
—
NC
Enumeration date
10/17/2016
Last updated
10/17/2016
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