Provider Demographics
NPI:1225759962
Name:ANGELS HOME CARE
Entity Type:Organization
Organization Name:ANGELS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWN
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAKIVA
Authorized Official - Middle Name:LASHUN
Authorized Official - Last Name:STAGGERS
Authorized Official - Suffix:
Authorized Official - Credentials:MEDICAL
Authorized Official - Phone:843-518-1712
Mailing Address - Street 1:820 CENTRAL AVE # C5
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-3743
Mailing Address - Country:US
Mailing Address - Phone:843-518-1712
Mailing Address - Fax:843-589-1239
Practice Address - Street 1:820 CENTRAL AVE # C5
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-3743
Practice Address - Country:US
Practice Address - Phone:843-518-1712
Practice Address - Fax:843-589-1239
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANGELS HOME CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-09-12
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health