Provider Demographics
NPI:1497538243
Name:ANGELS BEGINNING ,LLC
Entity Type:Organization
Organization Name:ANGELS BEGINNING ,LLC
Other - Org Name:ANGELS BEGINNING, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:E
Authorized Official - Last Name:NGALLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-775-0609
Mailing Address - Street 1:721 E FORGE AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-4916
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:721 E FORGE AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-4916
Practice Address - Country:US
Practice Address - Phone:480-687-5301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:1356066237
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness