Provider Demographics
NPI:1831525849
Name:ANGEL BEHAVIORAL CARE SERVICES, LLC
Entity type:Organization
Organization Name:ANGEL BEHAVIORAL CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:BOLAJI
Authorized Official - Middle Name:ADEOLA
Authorized Official - Last Name:AJIKE
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:856-628-0318
Mailing Address - Street 1:742 KINGS CROFT
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1109
Mailing Address - Country:US
Mailing Address - Phone:856-628-0318
Mailing Address - Fax:856-522-0537
Practice Address - Street 1:742 KINGS CROFT
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1109
Practice Address - Country:US
Practice Address - Phone:856-628-0318
Practice Address - Fax:856-522-0537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-23
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251C00000X
251S00000X, 252Y00000X, 253Z00000X, 261QD1600X, 261QP2000X, 261QX0100X, 347C00000X, 251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency
No253Z00000XAgenciesIn Home Supportive Care
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
No347C00000XTransportation ServicesPrivate Vehicle