Provider Demographics
NPI:1114365335
Name:ANGELS GIVING BACK SENIOR CARE
Entity Type:Organization
Organization Name:ANGELS GIVING BACK SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-500-0734
Mailing Address - Street 1:4489 CANTERBURY ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT OLIVE
Mailing Address - State:AL
Mailing Address - Zip Code:35117-3119
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4489 CANTERBURY ST
Practice Address - Street 2:
Practice Address - City:MOUNT OLIVE
Practice Address - State:AL
Practice Address - Zip Code:35117-3119
Practice Address - Country:US
Practice Address - Phone:205-500-0734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health