Provider Demographics
NPI:1275981391
Name:ANGELS OF OHIO
Entity Type:Organization
Organization Name:ANGELS OF OHIO
Other - Org Name:ANGELS OF OHIO
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SALEH
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHOUR
Authorized Official - Suffix:
Authorized Official - Credentials:MANAGER
Authorized Official - Phone:937-830-0303
Mailing Address - Street 1:4550 FOXTON CT
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-3935
Mailing Address - Country:US
Mailing Address - Phone:937-830-0303
Mailing Address - Fax:
Practice Address - Street 1:4550 FOXTON CT
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-3935
Practice Address - Country:US
Practice Address - Phone:937-830-0303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1275981391Medicaid