Provider Demographics
NPI:1023576832
Name:ANGELZ OF CARE SERVICES
Entity Type:Organization
Organization Name:ANGELZ OF CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HARRIETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-648-9615
Mailing Address - Street 1:3600 W PIONEER PKWY STE 17
Mailing Address - Street 2:
Mailing Address - City:PANTEGO
Mailing Address - State:TX
Mailing Address - Zip Code:76013-4525
Mailing Address - Country:US
Mailing Address - Phone:817-779-4039
Mailing Address - Fax:817-779-4008
Practice Address - Street 1:3600 W PIONEER PKWY STE 17
Practice Address - Street 2:
Practice Address - City:PANTEGO
Practice Address - State:TX
Practice Address - Zip Code:76013-4525
Practice Address - Country:US
Practice Address - Phone:817-779-4039
Practice Address - Fax:817-779-4008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health