Provider Demographics
NPI:1235457441
Name:ANGEL'S CARE IN HOME SERVICES
Entity Type:Organization
Organization Name:ANGEL'S CARE IN HOME SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:GRISSOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-240-8770
Mailing Address - Street 1:920 BENT OAK CT STE D
Mailing Address - Street 2:
Mailing Address - City:LAKE SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63367-1485
Mailing Address - Country:US
Mailing Address - Phone:636-240-8770
Mailing Address - Fax:636-240-8799
Practice Address - Street 1:920 BENT OAK CT STE D
Practice Address - Street 2:
Practice Address - City:LAKE SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63367-1485
Practice Address - Country:US
Practice Address - Phone:636-240-8770
Practice Address - Fax:636-240-8799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care