OrganizationActive
Angel Lane, LLC
NPI 1215389200 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Midlothian, VA
Provider details
- NPI number
- 1215389200
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Rifukat Adeyemi, Program Director(804) 833-0401
- License
- 2471 (VA)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense 2471 (VA)
Residential Treatment Facilities
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
11419 Courthouse Acres Dr
Midlothian, VA 23114-5168
Phone: (804) 833-0401
Street-level locationGet directions
Mailing address
11419 Courthouse Acres Dr
Midlothian, VA 23114-5168
Registry dates
- Enumerated
- 2016-07-01
- Last updated
- 2016-07-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.