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General NPI Number Information
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NPI Number | 1770139487
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Entity Type | Organization
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Legal Business Name | ANGELIAN MANAGEMENT GROUP LLC
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Dates
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Enumeration Date | 08/18/2019
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Last Update Date | 08/18/2019
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Provider Practice Location Address
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Address Line | 23551 MOULTON PKWY
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-1911
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Country | US
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Telephone | 949-707-1707
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Fax | 949-258-5117
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Provider Business Mailing Address
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Address Line | 23551 MOULTON PKWY
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-1911
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Country | US
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Telephone | 949-707-1707
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Fax | 949-258-5117
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MONA YACKO
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Credential |
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Telephone | 949-933-6546
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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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