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General NPI Number Information
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NPI Number | 1205310877
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Entity Type | Organization
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Legal Business Name | ANGELS DAY REHABILITATION CENTER
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Dates
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Enumeration Date | 09/19/2018
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Last Update Date | 09/19/2018
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Provider Practice Location Address
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Address Line | 625 PIONEER RD STE 102
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City | MESQUITE
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State | TX
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Zip | 75149-5286
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Country | US
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Telephone | 214-429-1691
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Fax | 469-573-6239
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Provider Business Mailing Address
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Address Line | 4017 SMARTT ST
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City | ROWLETT
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State | TX
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Zip | 75088-4953
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Country | US
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Telephone | 214-429-1691
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Fax | 469-573-6239
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Authorized Official
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Title or Position | DIRETOR
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Name | JACQUELINE BROOKS
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Credential |
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Telephone | 214-429-1691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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