Provider Demographics
NPI:1205310877
Name:ANGELS DAY REHABILITATION CENTER
Entity type:Organization
Organization Name:ANGELS DAY REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRETOR
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-429-1691
Mailing Address - Street 1:4017 SMARTT ST
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-4953
Mailing Address - Country:US
Mailing Address - Phone:214-429-1691
Mailing Address - Fax:469-573-6239
Practice Address - Street 1:625 PIONEER RD STE 102
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-5286
Practice Address - Country:US
Practice Address - Phone:214-429-1691
Practice Address - Fax:469-573-6239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services