Provider Demographics
NPI:1043668205
Name:ANGELIC HOME HEALTH LLC
Entity Type:Organization
Organization Name:ANGELIC HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:M
Authorized Official - Last Name:KORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-330-2908
Mailing Address - Street 1:1449 HIDEAWAY WOODS DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-5106
Mailing Address - Country:US
Mailing Address - Phone:614-330-2908
Mailing Address - Fax:
Practice Address - Street 1:1449 HIDEAWAY WOODS DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-5106
Practice Address - Country:US
Practice Address - Phone:614-330-2908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-28
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health