Provider Demographics
NPI:1316198245
Name:ANGEL STAR HOME HEALTH, INC.
Entity Type:Organization
Organization Name:ANGEL STAR HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLENDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-840-9023
Mailing Address - Street 1:9816 NOTTINGHILL LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-5006
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:110 SCOTT AVE
Practice Address - Street 2:SUITE 12
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7834
Practice Address - Country:US
Practice Address - Phone:336-889-3372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty