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General NPI Number Information
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NPI Number | 1871384180
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Entity Type | Organization
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Legal Business Name | ANGEL COMMUNITY ALLIANCE, INC
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Dates
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Enumeration Date | 05/15/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 508 BEACH 22ND ST
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-2678
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Country | US
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Telephone | 929-427-9677
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Fax | 516-268-9322
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Provider Business Mailing Address
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Address Line | 508 BEACH 22ND ST
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-2678
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Country | US
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Telephone | 929-427-9677
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Fax | 516-268-9322
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Authorized Official
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Title or Position | CEO
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Name | ANGELICKA JAMES
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Credential |
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Telephone | 929-426-9677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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