Provider Demographics
| NPI: | 1902948227 |
|---|---|
| Name: | NATIVE ANGELS TOTAL PROPERTY MANAGEMENT, LLC |
| Entity Type: | Organization |
| Organization Name: | NATIVE ANGELS TOTAL PROPERTY MANAGEMENT, LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | OWNER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | LESA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | JACOBS |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 910-734-4438 |
| Mailing Address - Street 1: | 2609 RAEFORD RD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | FAYETTEVILLE |
| Mailing Address - State: | NC |
| Mailing Address - Zip Code: | 28303-5433 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 910-668-1555 |
| Mailing Address - Fax: | 910-775-9246 |
| Practice Address - Street 1: | 2609 RAEFORD RD |
| Practice Address - Street 2: | |
| Practice Address - City: | FAYETTEVILLE |
| Practice Address - State: | NC |
| Practice Address - Zip Code: | 28303-5433 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 910-668-1555 |
| Practice Address - Fax: | 910-775-9246 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2007-02-13 |
| Last Update Date: | 2023-12-19 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| 101Y00000X, 106H00000X, 171M00000X, 2084P0800X, 2084P0804X, 225100000X, 2251P0200X, 225X00000X, 225XP0200X, 235Z00000X, 251S00000X, 253Z00000X | ||
| NC | HC1960 | 3747P1801X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | Group - Multi-Specialty | |
| No | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Multi-Specialty | |
| No | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | Group - Multi-Specialty | |
| No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
| No | 2084P0804X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry | Group - Multi-Specialty |
| No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
| No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | Group - Multi-Specialty |
| No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
| No | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | Group - Multi-Specialty |
| No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
| No | 251S00000X | Agencies | Community/Behavioral Health | Group - Multi-Specialty | |
| No | 253Z00000X | Agencies | In Home Supportive Care | Group - Multi-Specialty | |
| No | 3747P1801X | Nursing Service Related Providers | Technician | Personal Care Attendant | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| NC | 8300684J | Medicaid | |
| NC | 8700468 | Medicaid | |
| NC | 8300684 | Medicaid | |
| NC | 3409279 | Medicaid | |
| NC | 8300684B | Medicaid | |
| NC | 5905485 | Medicaid | |
| NC | 7211640 | Medicaid | |
| NC | 6005907 | Medicaid | |
| NC | 8300684G | Medicaid |
