Provider Demographics
NPI:1114073210
Name:ANGEL'S FAMILY CARE SERVICES
Entity Type:Organization
Organization Name:ANGEL'S FAMILY CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELENE
Authorized Official - Middle Name:LESA
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-975-1750
Mailing Address - Street 1:6400 GENERAL MEYER AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70131-2020
Mailing Address - Country:US
Mailing Address - Phone:504-393-0407
Mailing Address - Fax:504-393-0733
Practice Address - Street 1:6400 GENERAL MEYER AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70131-2020
Practice Address - Country:US
Practice Address - Phone:504-393-0407
Practice Address - Fax:504-393-0733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1565946251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1565946Medicaid