Provider Demographics
NPI:1316365083
Name:ANGEL'S SERVICES
Entity Type:Organization
Organization Name:ANGEL'S SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:RENEA
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-429-1691
Mailing Address - Street 1:111 SHADY CREEK LN
Mailing Address - Street 2:
Mailing Address - City:TERRELL
Mailing Address - State:TX
Mailing Address - Zip Code:75160-5138
Mailing Address - Country:US
Mailing Address - Phone:214-429-1691
Mailing Address - Fax:214-660-7353
Practice Address - Street 1:502 W KEARNEY ST STE 600
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-3426
Practice Address - Country:US
Practice Address - Phone:214-429-1691
Practice Address - Fax:214-660-7353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-31
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1316365083Medicaid