Provider Demographics
NPI:1275247686
Name:ANGELVILLE HEALTHCARE LLC
Entity Type:Organization
Organization Name:ANGELVILLE HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILIEN
Authorized Official - Middle Name:SHURI
Authorized Official - Last Name:ASOBO
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:978-398-1771
Mailing Address - Street 1:3896 SUMMIT POINTE APT 201
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-7696
Mailing Address - Country:US
Mailing Address - Phone:978-398-1771
Mailing Address - Fax:
Practice Address - Street 1:3896 SUMMIT POINTE APT 201
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-7696
Practice Address - Country:US
Practice Address - Phone:978-398-1771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health