Provider Demographics
NPI:1407310147
Name:AHADI ANGELS INCORPORATED
Entity Type:Organization
Organization Name:AHADI ANGELS INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ASINAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MACHARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-586-9406
Mailing Address - Street 1:405 WINTERFIELD DR # 204
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78634
Mailing Address - Country:US
Mailing Address - Phone:512-586-9406
Mailing Address - Fax:
Practice Address - Street 1:405 WINTERFIELD DR # 204
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78634
Practice Address - Country:US
Practice Address - Phone:512-586-9406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-28
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX27114686OtherSTATE