Provider Demographics
NPI:1235532359
Name:ANGELS CARE, INC
Entity Type:Organization
Organization Name:ANGELS CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NARDOS
Authorized Official - Middle Name:
Authorized Official - Last Name:MATUSALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-835-2694
Mailing Address - Street 1:2131 MURFREESBORO PIKE
Mailing Address - Street 2:SUITE L-1
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-3367
Mailing Address - Country:US
Mailing Address - Phone:615-835-2694
Mailing Address - Fax:615-835-2692
Practice Address - Street 1:2131 MURFREESBORO PIKE
Practice Address - Street 2:SUITE L-1
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-3367
Practice Address - Country:US
Practice Address - Phone:615-835-2694
Practice Address - Fax:615-835-2692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL000000013122253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNH445806Medicaid