Provider Demographics
NPI:1629440961
Name:ANGELES DEL CIELO
Entity Type:Organization
Organization Name:ANGELES DEL CIELO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING
Authorized Official - Prefix:
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-849-8978
Mailing Address - Street 1:11825 TRACY AUSTIN LN
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-6148
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11825 TRACY AUSTIN LN
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-6148
Practice Address - Country:US
Practice Address - Phone:915-849-8978
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No302F00000XManaged Care OrganizationsExclusive Provider Organization
No310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, ChildGroup - Multi-Specialty