Provider Demographics
NPI:1295369635
Name:ANGELES COMMUNITY MENTAL HEALTH, LLC.
Entity Type:Organization
Organization Name:ANGELES COMMUNITY MENTAL HEALTH, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:LISBEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-442-8336
Mailing Address - Street 1:13013 W LINEBAUGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-4451
Mailing Address - Country:US
Mailing Address - Phone:813-442-8336
Mailing Address - Fax:813-442-7188
Practice Address - Street 1:13013 W LINEBAUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-4451
Practice Address - Country:US
Practice Address - Phone:813-442-8336
Practice Address - Fax:813-442-7188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-25
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty