Provider Demographics
NPI:1437347747
Name:NATIVE ANGELS TOTAL PROPERTY MANAGEMENT, LLC
Entity Type:Organization
Organization Name:NATIVE ANGELS TOTAL PROPERTY MANAGEMENT, LLC
Other - Org Name:NATIVE ANGELS TOTAL PROPERTY MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LESA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:910-734-4438
Mailing Address - Street 1:2609 RAEFORD RD STE B
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-5433
Mailing Address - Country:US
Mailing Address - Phone:910-668-1555
Mailing Address - Fax:910-775-9423
Practice Address - Street 1:2609 RAEFORD RD STE B
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-5433
Practice Address - Country:US
Practice Address - Phone:910-668-1555
Practice Address - Fax:910-483-8609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 251J00000X, 251X00000X, 253Z00000X
NCHC34893747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty
No251J00000XAgenciesNursing Care
No251X00000XAgenciesSupports Brokerage
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601753Medicaid