Provider Demographics
NPI:1497227730
Name:ANGELIC TOUCH HOMECARE 1SERVICES INC.
Entity Type:Organization
Organization Name:ANGELIC TOUCH HOMECARE 1SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KOU
Authorized Official - Middle Name:LILA
Authorized Official - Last Name:SUMWABE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-678-6698
Mailing Address - Street 1:1501 NANCY ST
Mailing Address - Street 2:
Mailing Address - City:BARSTOW
Mailing Address - State:CA
Mailing Address - Zip Code:92311-2534
Mailing Address - Country:US
Mailing Address - Phone:909-678-8894
Mailing Address - Fax:
Practice Address - Street 1:1501 NANCY ST
Practice Address - Street 2:
Practice Address - City:BARSTOW
Practice Address - State:CA
Practice Address - Zip Code:92311-2534
Practice Address - Country:US
Practice Address - Phone:909-678-8894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-27
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health