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1033310172
ANASTACIA ANGEL
SALEM, OR
NPI
1033310172
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2007-05-29
Last Update Date
2007-07-08
Business Address
-- ANASTACIA ANGEL QMHA
2421 LANCASTER DR NE
SALEM, OR 97305-1220
Phone number: 503-561-2722
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Mailing Address
-- ANASTACIA ANGEL QMHA
4533 ARABIAN CT SE
SALEM, OR 97301-6024
Phone number: 503-361-3722
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