Provider Demographics
NPI:1558069047
Name:ANGEL ON MY SHOULDER INC
Entity Type:Organization
Organization Name:ANGEL ON MY SHOULDER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:J
Authorized Official - Last Name:FREEBORN
Authorized Official - Suffix:
Authorized Official - Credentials:RNBSN CCM
Authorized Official - Phone:949-485-8594
Mailing Address - Street 1:34145 PACIFIC COAST HWY
Mailing Address - Street 2:#308
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629
Mailing Address - Country:US
Mailing Address - Phone:888-391-4043
Mailing Address - Fax:888-582-4155
Practice Address - Street 1:7 TICKNOR PLACE
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677
Practice Address - Country:US
Practice Address - Phone:888-391-4043
Practice Address - Fax:888-582-4155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Multi-Specialty