Provider Demographics
NPI:1053637231
Name:RESCUE ANGELS ADULT CARE
Entity Type:Organization
Organization Name:RESCUE ANGELS ADULT CARE
Other - Org Name:RESCUE ANGELS CHILDCARE ACADEMY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/PROGRAM MGR.
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:DAVIS
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:AA
Authorized Official - Phone:817-821-7259
Mailing Address - Street 1:2808 MOUNT PISGAH RD
Mailing Address - Street 2:
Mailing Address - City:KILGORE
Mailing Address - State:TX
Mailing Address - Zip Code:75662-8356
Mailing Address - Country:US
Mailing Address - Phone:817-821-7259
Mailing Address - Fax:903-981-0450
Practice Address - Street 1:2808 MOUNT PISGAH RD
Practice Address - Street 2:
Practice Address - City:KILGORE
Practice Address - State:TX
Practice Address - Zip Code:75662-8356
Practice Address - Country:US
Practice Address - Phone:817-821-7259
Practice Address - Fax:903-981-0450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care