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ANGEL INTERVENTION SERVICES LLC
NPI 1801311121
Clinic/Center - Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) in Van Wert, OH

Active since August 08, 2017CLIA 36D2131233 · Waiver
123 S WASHINGTON ST, VAN WERT, OH 45891(419) 771-1050 Get Directions Write a Review

NPPES record last updated: July 12, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 12, 2023, Feb 15, 2023, Jul 25, 2022 and 3 more (6 updates tracked since 2017).

About Angel Intervention Services Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANGEL INTERVENTION SERVICES LLC (NPI 1801311121) is a healthcare organization registered as a rehabilitation, comprehensive outpatient rehabilitation facility (corf) in Van Wert, Ohio and active in the NPI registry since August 2017. The organization holds a CLIA Waiver certificate valid through May 23, 2027, maintains a secondary practice location in Van Wert, and lists Holly Lyn Conklin, Ceo/owner, as its authorized official.

NPPES Registry Identity

NPI1801311121
Entity TypeOrganization
Primary Taxonomy261QR0401X
Legal Business NameANGEL INTERVENTION SERVICES LLC
Location Address123 S WASHINGTON STVan Wert, OH 45891-1707
Mailing Address123 S Washington StVan Wert, OH 45891-1707 · (800) 430-2995 · Fax (419) 771-1051
Phone(419) 771-1050
Organization SubpartNo
Authorized OfficialHolly Lyn ConklinCeo/owner · (918) 500-2570
Enumeration DateAugust 8, 2017
Last NPPES UpdateJuly 12, 20236 updates tracked since enumeration
NPPES CertifiedJuly 12, 2023
✔ NPI 1801311121 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyClinic/Center · Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)Ambulatory Health Care Facilities
Taxonomy Code261QR0401X
Also ListedCounselorTaxonomy 101Y00000X
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
Also ListedCase ManagementTaxonomy 251B00000X
Also ListedSubstance Abuse Rehabilitation FacilityTaxonomy 324500000X
123 S WASHINGTON ST, Van Wert, OH 45891
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Secondary Practice Location 1

Location 1121 S Washington StVan Wert, OH 45891-1707 · Phone (419) 771-1050 · Fax (419) 771-1051

Other Identifiers 1

Medicaid0427664OH

Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D2131233

Angel Intervention Services LLC · Van Wert, OH
Active · expires May 23, 2027
CLIA Number36D2131233
Laboratory TypeIndependent
Certificate Effective DateMay 24, 2025
Certificate Expiration DateMay 23, 2027
Laboratory DirectorHolly L. Conklin
Laboratory Phone(419) 771-1050
Laboratory LocationAngel Intervention Services LLC123 S Washington St, Van Wert, OH 45891
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HANNAH MARIAH SUMMER ALVARADO CDCA
Case Manager/Care Coordinator
123 S WASHINGTON ST
VAN WERT, OH 45891
Van Wert County (419) 771-1050
AUDRA JANELLE ZINN CDCA PRELIMINARY
Counselor (Addiction (Substance Use Disorder))
123 S WASHINGTON ST
VAN WERT, OH 45891
Van Wert County (419) 771-1050
KARA N YOUNG
Case Manager/Care Coordinator
123 S WASHINGTON ST
VAN WERT, OH 45891
Van Wert County (419) 771-1050
MR. DAMION L BOYD SR. LPC
Counselor (Professional)
123 S WASHINGTON ST
VAN WERT, OH 45891
Van Wert County (419) 771-1050
HOLLY LYN CONKLIN CDC-A, CIP
Counselor (Addiction (Substance Use Disorder))
123 S WASHINGTON ST
VAN WERT, OH 45891
Van Wert County (918) 500-2570
KAYLA NICOLE THATCHER QMS
Case Manager/Care Coordinator
123 S WASHINGTON ST
VAN WERT, OH 45891
Van Wert County (419) 771-1050
THOMAS EDWARD WIDMANN QBHS
Counselor
123 S WASHINGTON ST
VAN WERT, OH 45891
Van Wert County (419) 771-1050
MICHAEL D. DOWDY MA, LSW, LICDC-CS
Social Worker
123 S WASHINGTON ST
VAN WERT, OH 45891
Van Wert County (419) 771-1050

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Angel Intervention Services LLC's NPI number?

The NPI number for Angel Intervention Services LLC is 1801311121. It was assigned to this organization in the NPPES registry on August 8, 2017.

Where is Angel Intervention Services LLC located?

Angel Intervention Services LLC is located at 123 S Washington St, Van Wert, OH 45891. The listed phone number is (419) 771-1050.

What is Angel Intervention Services LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF), with taxonomy code 261QR0401X.

Does Angel Intervention Services LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D2131233) is associated with this NPI, valid through May 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Angel Intervention Services LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 1 other insurer list Angel Intervention Services LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Angel Intervention Services LLC was last updated on July 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.