ANGEL WING RESIDENTIAL CARE HOME NPI 1497293559

NPI Information

ANGEL WING RESIDENTIAL CARE HOME is a community based residential treatment facility, intellectual and/or developmental disabilities in Demopolis, AL. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. ANGEL WING RESIDENTIAL CARE HOME NPI is 1497293559. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Residential Care Home.

The provider's business location address is:

803 FLOYD AVE
DEMOPOLIS, AL
ZIP 36732-157
Phone: (334) 349-6916

The provider's authorized official is Jacqueline Thomas Walls .
The authorized official title is Owner and has the following contact phone number (334) 349-6916.

The enumeration date for this NPI number is 2/8/2017 and was last updated on 2/8/2017.

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:

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