Provider Demographics
NPI:1730493271
Name:LITTLE ANGELS THERAPY, INC.
Entity Type:Organization
Organization Name:LITTLE ANGELS THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:DOYLE
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:828-302-2056
Mailing Address - Street 1:21 RIVER TERRACE CT
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28681-3920
Mailing Address - Country:US
Mailing Address - Phone:828-302-2055
Mailing Address - Fax:828-495-7700
Practice Address - Street 1:2121 12TH AVE NE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-3187
Practice Address - Country:US
Practice Address - Phone:828-578-6028
Practice Address - Fax:855-767-7030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-26
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X, 225X00000X, 235Z00000X
NCP-7142251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7211713Medicaid
NC7200384Medicaid