Provider Demographics
NPI:1174260574
Name:THE ANGEL HEART FOUNDATION
Entity Type:Organization
Organization Name:THE ANGEL HEART FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAUNEECE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS-MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-272-0019
Mailing Address - Street 1:1657 CLIFFVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-1110
Mailing Address - Country:US
Mailing Address - Phone:216-272-0019
Mailing Address - Fax:
Practice Address - Street 1:1657 CLIFFVIEW RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-1110
Practice Address - Country:US
Practice Address - Phone:216-272-0019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANGEL HEART
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-17
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health