Provider Demographics
NPI:1073788808
Name:ANGELES PRIMARY HOME CARE LLC
Entity Type:Organization
Organization Name:ANGELES PRIMARY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ETNA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-874-4844
Mailing Address - Street 1:1115 AMAPOLA
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-6555
Mailing Address - Country:US
Mailing Address - Phone:956-874-4844
Mailing Address - Fax:956-867-4844
Practice Address - Street 1:1115 AMAPOLA
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-6555
Practice Address - Country:US
Practice Address - Phone:956-874-4844
Practice Address - Fax:956-867-4844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty