Organization
ANGEL'S GROUP HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VALARIE CONSTANCE MCCULLERS (CEO)
(919) 963-9167
Entity
Organization
Contact information
Practice address
10590 CLEVELAND RD, GARNER, NC 27529-8187
(919) 963-9167
(919) 963-9168
Mailing address
10590 CLEVELAND ROAD, GARNER, NC 27529
(919) 963-9167
(919) 963-9168
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/28/2010
Last updated
06/28/2010
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