Provider Demographics
NPI:1093161622
Name:LIVING ANGELS HOME HEALTHCARE INC
Entity Type:Organization
Organization Name:LIVING ANGELS HOME HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:DENIZARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-267-2305
Mailing Address - Street 1:52 HILLCREST AVE
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-1459
Mailing Address - Country:US
Mailing Address - Phone:781-267-2305
Mailing Address - Fax:
Practice Address - Street 1:52 HILLCREST AVE
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-1459
Practice Address - Country:US
Practice Address - Phone:781-267-2305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health