Provider Demographics
NPI:1497750772
Name:ANGEL BRIGHT HOME HEALTH, INC
Entity Type:Organization
Organization Name:ANGEL BRIGHT HOME HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:BLANCH
Authorized Official - Middle Name:E
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-986-1102
Mailing Address - Street 1:3221 HOLLY RD
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78415-3216
Mailing Address - Country:US
Mailing Address - Phone:361-986-1102
Mailing Address - Fax:361-986-1152
Practice Address - Street 1:3221 HOLLY RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78415-3216
Practice Address - Country:US
Practice Address - Phone:361-986-1102
Practice Address - Fax:361-986-1152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-14
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008378251E00000X
3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX158328801Medicaid
TX158328801Medicaid