Provider Demographics
NPI:1598113425
Name:AANGELS ARMS PERSONAL CARE SERVICE LLC
Entity Type:Organization
Organization Name:AANGELS ARMS PERSONAL CARE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEGAY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:505-979-4933
Mailing Address - Street 1:PO BOX 3910
Mailing Address - Street 2:
Mailing Address - City:GALLUP
Mailing Address - State:NM
Mailing Address - Zip Code:87305-3910
Mailing Address - Country:US
Mailing Address - Phone:505-979-4933
Mailing Address - Fax:
Practice Address - Street 1:606 W AZTEC AVE
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-6516
Practice Address - Country:US
Practice Address - Phone:505-979-4933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care