Provider Demographics
NPI:1447770482
Name:DISPATCHED ANGELS HOME CARE
Entity Type:Organization
Organization Name:DISPATCHED ANGELS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:CRYSTAL
Authorized Official - Last Name:DORSEY
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:706-940-8126
Mailing Address - Street 1:619 EL PRADO CT
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-3822
Mailing Address - Country:US
Mailing Address - Phone:706-940-8126
Mailing Address - Fax:678-785-4112
Practice Address - Street 1:619 EL PRADO COURT
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083
Practice Address - Country:US
Practice Address - Phone:706-940-8126
Practice Address - Fax:678-785-4112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044-R-1759253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care