Provider Demographics
NPI:1346789211
Name:ANGEL HCS, LLC
Entity Type:Organization
Organization Name:ANGEL HCS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:W
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:346-298-3339
Mailing Address - Street 1:14423 CYPRESS LINKS TRL
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-4200
Mailing Address - Country:US
Mailing Address - Phone:346-298-3339
Mailing Address - Fax:346-298-3339
Practice Address - Street 1:14423 CYPRESS LINKS TRL
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-4200
Practice Address - Country:US
Practice Address - Phone:346-298-3339
Practice Address - Fax:346-570-1019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-13
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services