Provider Demographics
NPI:1679225064
Name:AMAZING ANGELS LLC
Entity Type:Organization
Organization Name:AMAZING ANGELS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELANY
Authorized Official - Middle Name:
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-635-4734
Mailing Address - Street 1:PO BOX 274
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-0274
Mailing Address - Country:US
Mailing Address - Phone:720-635-4734
Mailing Address - Fax:720-420-1322
Practice Address - Street 1:4810 JET WING CIR W
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80916-2149
Practice Address - Country:US
Practice Address - Phone:720-635-4734
Practice Address - Fax:720-420-1322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities