Provider Demographics
NPI:1043996440
Name:1-ANGEL HOMECARE
Entity Type:Organization
Organization Name:1-ANGEL HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IFEOMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ONYIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-920-8389
Mailing Address - Street 1:8505 NETHERFIELD CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-1855
Mailing Address - Country:US
Mailing Address - Phone:704-920-8389
Mailing Address - Fax:
Practice Address - Street 1:11020 DAVID TAYLOR DR STE 316
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-1101
Practice Address - Country:US
Practice Address - Phone:704-920-8389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health