Provider Demographics
NPI:1508203407
Name:TOUCH BY AN ANGEL HEALTHCARE INC.
Entity Type:Organization
Organization Name:TOUCH BY AN ANGEL HEALTHCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:HURST
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:706-814-9691
Mailing Address - Street 1:2861 TOBACCO RD
Mailing Address - Street 2:
Mailing Address - City:HEPHZIBAH
Mailing Address - State:GA
Mailing Address - Zip Code:30815-7003
Mailing Address - Country:US
Mailing Address - Phone:706-790-5836
Mailing Address - Fax:706-790-0767
Practice Address - Street 1:2861 TOBACCO RD
Practice Address - Street 2:
Practice Address - City:HEPHZIBAH
Practice Address - State:GA
Practice Address - Zip Code:30815-7003
Practice Address - Country:US
Practice Address - Phone:706-790-5836
Practice Address - Fax:706-790-0767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALCB20120001059302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization