Provider Demographics
NPI:1952842056
Name:ANGEL COORDINATION INC.
Entity Type:Organization
Organization Name:ANGEL COORDINATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CECELIA
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:BLACKSTON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:267-432-1502
Mailing Address - Street 1:67 BUCK RD STE B57
Mailing Address - Street 2:HUNTINGDON VALLEY
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-1540
Mailing Address - Country:US
Mailing Address - Phone:215-490-6810
Mailing Address - Fax:
Practice Address - Street 1:67 BUCK RD
Practice Address - Street 2:HUNTINGDON VALLEY B 53
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-1535
Practice Address - Country:US
Practice Address - Phone:215-450-9119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management