Provider Demographics
NPI:1477005759
Name:FOREVER ANGELS INC
Entity Type:Organization
Organization Name:FOREVER ANGELS INC
Other - Org Name:FOREVER ANGELS ADULT DAY CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-554-9379
Mailing Address - Street 1:831 ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30830-1269
Mailing Address - Country:US
Mailing Address - Phone:706-554-9379
Mailing Address - Fax:
Practice Address - Street 1:831 ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:GA
Practice Address - Zip Code:30830-1269
Practice Address - Country:US
Practice Address - Phone:706-554-9379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care