Provider Demographics
NPI:1376221564
Name:ANGEL HOME CARE LLC
Entity Type:Organization
Organization Name:ANGEL HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBR
Authorized Official - Prefix:MS
Authorized Official - First Name:KAMINI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-874-4969
Mailing Address - Street 1:512 MIDDLESEX AVE
Mailing Address - Street 2:
Mailing Address - City:COLONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07067-3226
Mailing Address - Country:US
Mailing Address - Phone:732-874-4969
Mailing Address - Fax:908-756-4359
Practice Address - Street 1:15 WOOD AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3503
Practice Address - Country:US
Practice Address - Phone:732-874-4969
Practice Address - Fax:908-756-4359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care