Healthcare Provider Details

I. General information

NPI: 1437090446
Provider Name (Legal Business Name): ANGELS IN THE OUTFIELD AITO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/05/2026
Certification Date: 04/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8701 W OLYMPIC BLVD
LOS ANGELES CA
90035-1907
US

IV. Provider business mailing address

6116 COLFAX AVE
NORTH HOLLYWOOD CA
91606-4709
US

V. Phone/Fax

Practice location:
  • Phone: 747-228-0544
  • Fax: 747-228-0544
Mailing address:
  • Phone: 747-228-0544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MEAGAN N HEUCHAN
Title or Position: FOUNDER/CEO
Credential: SUD ADVOCATE
Phone: 747-228-0544