Provider Demographics
NPI:1508508292
Name:EARTH ANGELS HEALTHCARE, LLC.
Entity Type:Organization
Organization Name:EARTH ANGELS HEALTHCARE, LLC.
Other - Org Name:EARTH ANGELS HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NSIKAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ESENOWO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-890-1351
Mailing Address - Street 1:22217 VERBENA PKWY
Mailing Address - Street 2:
Mailing Address - City:SPICEWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:78669-6306
Mailing Address - Country:US
Mailing Address - Phone:512-668-9561
Mailing Address - Fax:855-746-0001
Practice Address - Street 1:22217 VERBENA PKWY
Practice Address - Street 2:
Practice Address - City:SPICEWOOD
Practice Address - State:TX
Practice Address - Zip Code:78669-6306
Practice Address - Country:US
Practice Address - Phone:512-668-9561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-12
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX021192OtherTEXAS HHSC