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NPI Code Detail

MEDICARE: 1ANGEL ARMS FAMILY CARE LLC

MEDICARE: 1ANGEL ARMS FAMILY CARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251C00000XDevelopmentally Disabled Services Day Training Agency

General Provider Information

NPI Number : 1366866832
Entity Type Code : Organization
Provider Name (Legal Business Name) : 1ANGEL ARMS FAMILY CARE LLC
Provider Business Mailing Address
First Line : 12125 HIGHWAY 6 STE E
Second Line :
City : FRESNO
State : TX
Zip : 77545-8844
Country : US
Telephone Number : 832-329-2277
Fax Number :
Provider Business Practice Location Address
First Line : 12125 HIGHWAY 6 STE E
Second Line :
City : FRESNO
State : TX
Zip : 77545-8844
Country : US
Telephone Number : 832-329-2277
Fax Number :
Authorized Official
Title or Position : PROGRAM DIRECTOR
Name : SOPHIA DAVIS-FIELDS
Credential :
Telephone Number : 832-329-2277
Provider Enumeration Date : 02/05/2014
Last Update Date : 02/05/2014

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Directions to “1ANGEL ARMS FAMILY CARE LLC ” Practice Location

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