Provider Demographics
NPI:1093951576
Name:ANGELS ON ASSIGNMENT HOME HEALTH AGENCY LLC
Entity Type:Organization
Organization Name:ANGELS ON ASSIGNMENT HOME HEALTH AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:NANNETTE
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:614-260-1926
Mailing Address - Street 1:PO BOX 13108
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:OH
Mailing Address - Zip Code:43213-2531
Mailing Address - Country:US
Mailing Address - Phone:614-446-8363
Mailing Address - Fax:614-604-9285
Practice Address - Street 1:5027 ETNA RD,
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:OH
Practice Address - Zip Code:43213-2531
Practice Address - Country:US
Practice Address - Phone:614-446-8363
Practice Address - Fax:614-604-9285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.081736251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2860953OtherMRDD INDIVIDUAL