TYREK'S HEAVENLY ANGELS NPI 1780726992

NPI Information

NPI: 1780726992
Provider Name: TYREK'S HEAVENLY ANGELS
Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address:
1830 EICHELBERGER DR
FAYETTEVILLE, NC
ZIP 28303
Phone: (910) 425-6841
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TYREK'S HEAVENLY ANGELS is a residential treatment facility, intellectual and/or developmental disabilities in Fayetteville, NC. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. TYREK'S HEAVENLY ANGELS NPI is 1780726992. The provider is registered as an organization entity type.

The provider's business location address is:

1830 EICHELBERGER DR
FAYETTEVILLE, NC
ZIP 28303-257
Phone: (910) 425-6841
Fax: (910) 485-4005

The provider's authorized official is Patricia Ann Hill .
The authorized official title is Ceo and has the following contact phone number (910) 425-6841.

The enumeration date for this NPI number is 2/13/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities		MHL026770	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	6603559	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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