Organization
HOLY ANGELS INC.
Active
Other names
LifeChoices
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA MOODY (PRESIDENT/CEO)
(704) 829-4402
Entity
Organization
Contact information
Practice address
6600 W WILKINSON BLVD, BELMONT, NC 28012-2796
(704) 825-4161
Mailing address
6600 W WILKINSON BLVD, BELMONT, NC 28012-2796
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251J00000X
Nursing Care Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
MHL-036-012
NC
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
MHL-036-012
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619310851
STATE FUNDS THROUGH PARTNERS MCO
NC
05
—
3408854
—
NC
Enumeration date
09/24/2012
Last updated
03/26/2018
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