Provider Demographics
NPI:1992190128
Name:MIANGEL RELIABLE CARE LLC
Entity type:Organization
Organization Name:MIANGEL RELIABLE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARIAMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-287-5477
Mailing Address - Street 1:1400 RIVERS EDGE TRCE
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-5749
Mailing Address - Country:US
Mailing Address - Phone:757-287-5477
Mailing Address - Fax:757-397-7759
Practice Address - Street 1:443 BROAD ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23707-2003
Practice Address - Country:US
Practice Address - Phone:757-287-5477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-03
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility