Provider Demographics
NPI:1013190834
Name:ANGELS COMMUNITY MENTAL HEALTH PA
Entity Type:Organization
Organization Name:ANGELS COMMUNITY MENTAL HEALTH PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YSABEL
Authorized Official - Middle Name:NARRO
Authorized Official - Last Name:LLANES
Authorized Official - Suffix:
Authorized Official - Credentials:MS,MHC
Authorized Official - Phone:305-300-5551
Mailing Address - Street 1:8370 W FLAGLER ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2094
Mailing Address - Country:US
Mailing Address - Phone:305-300-5551
Mailing Address - Fax:305-228-6571
Practice Address - Street 1:8370 W FLAGLER ST
Practice Address - Street 2:SUITE 210
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2094
Practice Address - Country:US
Practice Address - Phone:305-300-5551
Practice Address - Fax:305-228-6571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-15
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health