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General NPI Number Information
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NPI Number | 1003380387
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Entity Type | Organization
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Legal Business Name | ANGEL HEART ADULT DAYCARE, LLC
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Dates
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Enumeration Date | 01/19/2019
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Last Update Date | 02/02/2019
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Provider Practice Location Address
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Address Line | 6612 COTTONWOOD GROVE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80925-1302
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Country | US
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Telephone | 719-650-8221
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Fax |
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Provider Business Mailing Address
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Address Line | 6612 COTTONWOOD GROVE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80925-1302
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Country | US
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Telephone | 719-650-8221
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMIN
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Name | MRS. BRITTANY NICHOLE ALSHAWY
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Credential |
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Telephone | 719-650-8221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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