Provider Demographics
NPI:1164882593
Name:ARMS OF AN ANGEL PROVIDER & IN- HOME SKILLED NURSING SERVICES
Entity Type:Organization
Organization Name:ARMS OF AN ANGEL PROVIDER & IN- HOME SKILLED NURSING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PRACTICAL NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANA-LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALES
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:210-218-7406
Mailing Address - Street 1:9851 MESSENGER PASS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-2839
Mailing Address - Country:US
Mailing Address - Phone:210-218-7406
Mailing Address - Fax:210-455-0542
Practice Address - Street 1:9851 MESSENGER PASS
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-2839
Practice Address - Country:US
Practice Address - Phone:210-218-7406
Practice Address - Fax:210-437-3636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-26
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX304600251B00000X, 251J00000X, 252Y00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care
No252Y00000XAgenciesEarly Intervention Provider Agency