Provider Demographics
NPI:1518416767
Name:ANGEL CARE ADULT DAYCARE
Entity Type:Organization
Organization Name:ANGEL CARE ADULT DAYCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:EDMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-842-5544
Mailing Address - Street 1:1945 SARAH ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77705-3341
Mailing Address - Country:US
Mailing Address - Phone:409-842-5544
Mailing Address - Fax:409-842-5252
Practice Address - Street 1:1945 SARAH ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77705-3341
Practice Address - Country:US
Practice Address - Phone:409-842-5544
Practice Address - Fax:409-842-5252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-29
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care