Organization
TYREK'S HEAVENLY ANGELS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA ANN HILL (CEO)
(910) 425-6841
Entity
Organization
Contact information
Practice address
1830 EICHELBERGER DR, FAYETTEVILLE, NC 28303-6257
(910) 425-6841
(910) 485-4005
Mailing address
1716 BENT CREEK DR, HOPE MILLS, NC 28348
(910) 425-6841
(910) 485-4005
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL026770
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603559
—
NC
Enumeration date
02/13/2007
Last updated
08/22/2020
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