Provider Demographics
NPI:1467829648
Name:ANGEL CARE ATTENDANTS
Entity Type:Organization
Organization Name:ANGEL CARE ATTENDANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:JAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-696-5717
Mailing Address - Street 1:10640 N 28TH DR STE C209
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-2936
Mailing Address - Country:US
Mailing Address - Phone:602-696-5717
Mailing Address - Fax:877-347-6092
Practice Address - Street 1:10640 N 28TH DR STE C209
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-2936
Practice Address - Country:US
Practice Address - Phone:602-696-5717
Practice Address - Fax:877-347-6092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)