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NPI Code Detail

MEDICARE: ANGEL LEE SERVICES, LLC

MEDICARE: ANGEL LEE SERVICES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management Agency
2251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1235718024
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANGEL LEE SERVICES, LLC
Provider Business Mailing Address
First Line : 6201 FAIRVIEW RD STE 200
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-3297
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6201 FAIRVIEW RD STE 200
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-3297
Country : US
Telephone Number : 843-372-2928
Fax Number :
Authorized Official
Title or Position : OWNER/CEO
Name : MR. ALDRICK DWIGHT BARR
Credential :
Telephone Number : 843-372-2928
Provider Enumeration Date : 04/07/2021
Last Update Date : 04/07/2021

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Directions to “ANGEL LEE SERVICES, LLC ” Practice Location

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