Provider Demographics
NPI:1629803804
Name:ANGELES ESPECIALES PARENT SUPPORT GROUP
Entity type:Organization
Organization Name:ANGELES ESPECIALES PARENT SUPPORT GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NERI
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:909-699-3614
Mailing Address - Street 1:17644 VINE CT
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-3768
Mailing Address - Country:US
Mailing Address - Phone:909-699-3614
Mailing Address - Fax:
Practice Address - Street 1:17644 VINE CT
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-3768
Practice Address - Country:US
Practice Address - Phone:909-699-3614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable