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General NPI Number Information
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NPI Number | 1336411628
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Entity Type | Organization
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Legal Business Name | R & R'S ANGEL'S, LLC
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Dates
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Enumeration Date | 02/01/2012
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Last Update Date | 02/01/2012
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Provider Practice Location Address
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Address Line | 4501 DURALEIGH RD
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City | RALEIGH
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State | NC
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Zip | 27612-3533
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Country | US
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Telephone | 919-896-7469
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Fax |
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Provider Business Mailing Address
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Address Line | 4832 SILVERDENE ST
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City | RALEIGH
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State | NC
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Zip | 27616-5112
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Country | US
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Telephone | 919-896-7469
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Fax |
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Authorized Official
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Title or Position | ORGA NIZER/MEMBER (OWNER)
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Name | TENEISHA NICOLE HARDISON
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Credential | MA
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Telephone | 919-896-7469
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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