Provider Demographics
NPI:1083661599
Name:ANGELS UNLIMITED HOME HEALTH, INC
Entity Type:Organization
Organization Name:ANGELS UNLIMITED HOME HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYANT
Authorized Official - Middle Name:C
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-680-8829
Mailing Address - Street 1:4211 GARDENDALE ST
Mailing Address - Street 2:SUITE 105A
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3180
Mailing Address - Country:US
Mailing Address - Phone:210-680-8829
Mailing Address - Fax:
Practice Address - Street 1:4211 GARDENDALE ST
Practice Address - Street 2:SUITE 105A
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3180
Practice Address - Country:US
Practice Address - Phone:210-680-8829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009820251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX457917Medicare ID - Type UnspecifiedHOME HEALTH