Provider Demographics
NPI:1376204826
Name:ANGELS IN FLIGHT HOME CARE INC.
Entity Type:Organization
Organization Name:ANGELS IN FLIGHT HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BACCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-600-3435
Mailing Address - Street 1:PO BOX 5532
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-0609
Mailing Address - Country:US
Mailing Address - Phone:661-600-3435
Mailing Address - Fax:
Practice Address - Street 1:10319 S 175TH AVE
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338
Practice Address - Country:US
Practice Address - Phone:661-600-3435
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health