Provider Demographics
NPI:1023790243
Name:CC NESTING ANGELS LLC
Entity type:Organization
Organization Name:CC NESTING ANGELS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHANELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-609-8961
Mailing Address - Street 1:339 COLLINS DR
Mailing Address - Street 2:
Mailing Address - City:PENN HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15235-3839
Mailing Address - Country:US
Mailing Address - Phone:412-609-8961
Mailing Address - Fax:
Practice Address - Street 1:339 COLLINS DR
Practice Address - Street 2:
Practice Address - City:PENN HILLS
Practice Address - State:PA
Practice Address - Zip Code:15235-3839
Practice Address - Country:US
Practice Address - Phone:412-609-8961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities