Provider Demographics
NPI:1669789905
Name:ANGELS RECOVERY AND SPIRITUALITY
Entity type:Organization
Organization Name:ANGELS RECOVERY AND SPIRITUALITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLEDO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:404-363-7890
Mailing Address - Street 1:914 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FOREST PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30297-1474
Mailing Address - Country:US
Mailing Address - Phone:404-363-7890
Mailing Address - Fax:404-363-3923
Practice Address - Street 1:914 MAIN ST
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:GA
Practice Address - Zip Code:30297-1474
Practice Address - Country:US
Practice Address - Phone:404-363-7890
Practice Address - Fax:404-363-3923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health