Provider Demographics
NPI:1255170338
Name:TOUCHED BY AN ANGEL, INC.
Entity type:Organization
Organization Name:TOUCHED BY AN ANGEL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:RODINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELIASNIK
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:310-701-0860
Mailing Address - Street 1:5595 HUNTINGTON DR N
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90032-1362
Mailing Address - Country:US
Mailing Address - Phone:323-576-2938
Mailing Address - Fax:
Practice Address - Street 1:5595 HUNTINGTON DR N
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90032-1362
Practice Address - Country:US
Practice Address - Phone:323-576-2938
Practice Address - Fax:323-544-0779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty