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General NPI Number Information
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NPI Number | 1699076646
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Entity Type | Organization
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Legal Business Name | ANGELS HOUSE LLC
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Dates
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Enumeration Date | 11/08/2010
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Last Update Date | 03/11/2016
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Provider Practice Location Address
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Address Line | 6646 W ATLANTIC AVE
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City | DELRAY BEACH
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State | FL
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Zip | 33446-1627
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Country | US
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Telephone | 561-900-9308
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Fax | 561-900-9319
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Provider Business Mailing Address
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Address Line | 222 PROFESSIONAL WAY
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City | WELLINGTON
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State | FL
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Zip | 33414-6391
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Country | US
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Telephone | 561-900-9308
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Fax | 561-900-9319
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. EDDIE HURTADO
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Credential |
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Telephone | 561-900-9312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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