HEAVENLY ANGELS GROUP HOME, INC (NPI# 1457591356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457591356 |
| Entity Type | Organization |
| Organization Name | HEAVENLY ANGELS GROUP HOME, INC |
| Practice Address |
3725 Anita Ln Greensboro NC 27405-9412 |
| Mailing Address |
503 W Mcgee St Greensboro NC 27401-2702 |
| Practice Telephone | 3363582137 |
| Practice Fax Number | 3363582136 |
| Mailing Telephone | 3362300808 |
| Mailing Fax Number | 3362300842 |
| Enumeration Date | 2009-03-05 |
| Last Update Date | 2009-03-05 |
| Authorized Official Name | MS. ANTOINETTA DEMTRIA FULTON (ONWER/ DIRECTOR) |
| Authorized Official Telephone | 3362300808 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | MHL-041-895 | NC | Residential Treatment Facilities |
| Street Address |
3725 ANITA LN |
| City | GREENSBORO |
| State | NC |
| Zip Code | 27405-9412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396042057 | Heavely Angels | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3725 Anita Ln, Greensboro, NC 27405-9412 | 2011-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477038727 | Miya Jackson | Behavior Technician | 2308 Golden Gate Dr, Apt G, Greensboro, NC 27405 | 2018-10-02 |
| 1821576299 | Woodrow Eric Bradley | Day Training/Habilitation Specialist | 1403 Woocbriar Ave, Greensboro, NC 27405 | 2018-07-30 |
| 1922593094 | Constance Foushee | Nurse Practitioner | 1100 E. Wendover, Greensboro, NC 27405 | 2018-06-29 |
| 1760972434 | Ayana Linette Holland | Home Health Aide | 1417 Old Hickory Dr, Greensboro, NC 27405 | 2018-05-17 |
| 1790294700 | G. Antoine Gray | Specialist | 2100 Phillips Avenue, Suite B, Greensboro, NC 27405 | 2017-09-21 |
| 1306375910 | Wendy Carisa Boger | Registered Nurse | 1100 East Wendover Avenue, Greensboro, NC 27405 | 2017-06-07 |
| 1659827715 | Changing Paths Counseling Center Pllc | Community/Behavioral Health | 1600 E Wendoer Ave., Suite C, Greensboro, NC 27405 | 2016-08-29 |
| 1295187896 | Amanda Kirby Counseling, PC | Counselor | 1175 Revolution Mill Drive, Suite 29-2, Greensboro, NC 27405 | 2016-07-07 |
| 1780049429 | Pta | Residential Treatment Facility, Physical Disabilities | 1900 Sheldon Road, Greensboro, NC 27405 | 2015-12-23 |
| 1841655644 | Amaya Nicole Hardy | Counselor | 1600r E Wendover Ave Ste R, Greensboro, NC 27405 | 2015-12-21 |
| Find all providers in zip 27405 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487131074 | Ronald Anthony Benjamin | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1594 Candace Ridge Dr, Greensboro, NC 27406-8595 | 2018-07-26 |
| 1477045714 | Jacqueline Kirby | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5212 Fox Hunt Dr Apt A, Greensboro, NC 27407-7118 | 2018-06-02 |
| 1326568239 | Agape Home Living Care, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2708 16th Street, Greensboro, NC 24239-4371 | 2017-06-21 |
| 1831547728 | Something Special | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1725 Fairfax Rd Apt D, Greensboro, NC 27407-4121 | 2016-06-01 |
| 1346605649 | Wescare Professional Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1600 Harrod Ln, Greensboro, NC 27410-8207 | 2015-12-31 |
| 1427475789 | Wescare Professional Services, LLC. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5909 Boxelder Cv, Greensboro, NC 27405-8241 | 2014-03-25 |
| 1982021796 | Wescare Professional Services, LLC. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1938 Vanstory St, Greensboro, NC 27403-3644 | 2014-03-19 |
| 1639596448 | Wescare Professional Services, LLC. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1523 Glenridge Rd, Greensboro, NC 27405-5425 | 2014-03-19 |
| 1942562772 | Better Life Choices | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 203 Kinnley Ct, Greensboro, NC 27455-0971 | 2012-06-07 |
| 1689930547 | Hicks House of Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2611 Zola Dr, Greensboro, NC 27405-2613 | 2012-04-05 |
| Find all providers in GREENSBORO | ||||
| City | GREENSBORO |
| Zip Code | 27405 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.