Provider Demographics
NPI:1437846565
Name:AMANDAS ANGELS
Entity Type:Organization
Organization Name:AMANDAS ANGELS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:MAYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-316-2570
Mailing Address - Street 1:202 30TH ST SW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44706-5600
Mailing Address - Country:US
Mailing Address - Phone:330-316-2570
Mailing Address - Fax:
Practice Address - Street 1:202 30TH ST SW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44706-5600
Practice Address - Country:US
Practice Address - Phone:330-316-2570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services