Angel Wing Residential Care Home

NPI #1497293559 in Demopolis, Alabama

Provider Information

NPI Number: 1497293559
Entity Type: Organization
Organization Name: Angel Wing Residential Care Home
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Feb 8, 2017
Last Updated: Feb 8, 2017

Practice Location

Address: 803 FLOYD AVE
City: Demopolis
State: Alabama
ZIP Code: 36732-3157
Phone: (334) 349-6916

Authorized Official

Name: JACQUELINE THOMAS WALLS
Title: OWNER
Phone: (334) 349-6916

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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