Provider Demographics
NPI:1518513100
Name:ANGELS GATE HEALTHCARE LLC
Entity Type:Organization
Organization Name:ANGELS GATE HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOSPICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDEE
Authorized Official - Middle Name:
Authorized Official - Last Name:TEMMIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:702-857-0839
Mailing Address - Street 1:217 ARROWHEAD BLVD STE A2
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-1169
Mailing Address - Country:US
Mailing Address - Phone:678-510-6794
Mailing Address - Fax:
Practice Address - Street 1:217 ARROWHEAD BLVD STE A2
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-1169
Practice Address - Country:US
Practice Address - Phone:678-510-6794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-10
Last Update Date:2019-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based