Healthcare Provider Details

I. General information

NPI: 1427976810
Provider Name (Legal Business Name): ANGEL THERAPEUTIC HOMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 CHINQUAPIN WAY
SACRAMENTO CA
95823-6323
US

IV. Provider business mailing address

8117 GENEX WAY
ELK GROVE CA
95757-6207
US

V. Phone/Fax

Practice location:
  • Phone: 916-821-3265
  • Fax:
Mailing address:
  • Phone: 916-821-3265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name: SHELVIN LAL
Title or Position: R&B OPERATOR
Credential:
Phone: 916-821-3265