Provider Demographics
NPI:1083982698
Name:ANGEL CAREGIVER SERVICES
Entity Type:Organization
Organization Name:ANGEL CAREGIVER SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LONNIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:OGLESBY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:912-660-3708
Mailing Address - Street 1:301 W 41ST ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-8821
Mailing Address - Country:US
Mailing Address - Phone:912-660-3708
Mailing Address - Fax:
Practice Address - Street 1:301 W 41ST ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-8821
Practice Address - Country:US
Practice Address - Phone:912-660-3708
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization