Provider Demographics
NPI:1346792470
Name:ANGELS ON CALL HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:ANGELS ON CALL HOME CARE AGENCY LLC
Other - Org Name:ANGELS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:MAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:ADMIN
Authorized Official - Phone:470-800-1220
Mailing Address - Street 1:4920 WINDY HILL DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-5193
Mailing Address - Country:US
Mailing Address - Phone:470-800-1220
Mailing Address - Fax:
Practice Address - Street 1:4920 WINDY HILL DR
Practice Address - Street 2:SUITE A
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-5193
Practice Address - Country:US
Practice Address - Phone:470-800-1220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4043253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care