Provider Demographics
NPI:1275065278
Name:ARLENE'S EMBRACING ANGELS LLC
Entity Type:Organization
Organization Name:ARLENE'S EMBRACING ANGELS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHALA
Authorized Official - Middle Name:S
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-406-0165
Mailing Address - Street 1:PO BOX 260
Mailing Address - Street 2:
Mailing Address - City:BRENHAM
Mailing Address - State:TX
Mailing Address - Zip Code:77834-0260
Mailing Address - Country:US
Mailing Address - Phone:979-406-0165
Mailing Address - Fax:
Practice Address - Street 1:2681 CANTEY ST APT 42
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-2465
Practice Address - Country:US
Practice Address - Phone:979-406-0165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health