Provider Demographics
NPI:1003983180
Name:LITTLE ANGELS HOME CARE
Entity Type:Organization
Organization Name:LITTLE ANGELS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:O
Authorized Official - Last Name:OLUOKUN
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:770-736-0666
Mailing Address - Street 1:2989 RUSTICWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-2871
Mailing Address - Country:US
Mailing Address - Phone:770-736-0666
Mailing Address - Fax:770-982-7005
Practice Address - Street 1:2989 RUSTICWOOD DR
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-2871
Practice Address - Country:US
Practice Address - Phone:770-736-0666
Practice Address - Fax:770-982-7005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044-R-0188251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care