Provider Demographics
NPI:1235613159
Name:ESTHER ANGELS HOMECARE AND ASSISTED LIVING SERVICES
Entity Type:Organization
Organization Name:ESTHER ANGELS HOMECARE AND ASSISTED LIVING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:OLUSEGUN
Authorized Official - Middle Name:
Authorized Official - Last Name:AJIBADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-519-3088
Mailing Address - Street 1:100 LLOYD AVE STE B
Mailing Address - Street 2:
Mailing Address - City:TYRONE
Mailing Address - State:GA
Mailing Address - Zip Code:30290-2157
Mailing Address - Country:US
Mailing Address - Phone:678-519-3088
Mailing Address - Fax:800-273-7168
Practice Address - Street 1:100 LLOYD AVE STE B
Practice Address - Street 2:
Practice Address - City:TYRONE
Practice Address - State:GA
Practice Address - Zip Code:30290-2157
Practice Address - Country:US
Practice Address - Phone:678-519-3088
Practice Address - Fax:800-273-7168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health