Organization
JAVINCHIS ANGELS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY HORN (EXECUTIVE DIRECTOR)
(970) 471-5641
Entity
Organization
Contact information
Practice address
4397 SW BREEZY POINT LN, LEES SUMMIT, MO 64082-4772
(970) 471-5641
Mailing address
1404 SW MARKET ST UNIT 1216, LEES SUMMIT, MO 64063-3100
(970) 471-5641
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251F00000X
Home Infusion Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
310400000X
Assisted Living Facility
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
311Z00000X
Custodial Care Facility
—
—
311ZA0620X
Adult Care Home Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/18/2025
Last updated
06/18/2025
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