Provider Demographics
NPI:1245409549
Name:ARMS OF AN ANGEL, LLC
Entity Type:Organization
Organization Name:ARMS OF AN ANGEL, LLC
Other - Org Name:WILLIE TRAVIS STANSBURY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:TRAVIS
Authorized Official - Last Name:STANSBURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-907-6081
Mailing Address - Street 1:1502 MAIN ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FRANKLIN
Mailing Address - State:LA
Mailing Address - Zip Code:70538-3743
Mailing Address - Country:US
Mailing Address - Phone:337-907-6275
Mailing Address - Fax:337-907-6288
Practice Address - Street 1:1502 MAIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:FRANKLIN
Practice Address - State:LA
Practice Address - Zip Code:70538-3743
Practice Address - Country:US
Practice Address - Phone:337-907-6275
Practice Address - Fax:337-907-6288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPC0007469251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health