Provider Demographics
NPI:1619723186
Name:ANGELS HEART HOME CARE SERVICES
Entity Type:Organization
Organization Name:ANGELS HEART HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PINKY
Authorized Official - Middle Name:G
Authorized Official - Last Name:LIBREA
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CEN
Authorized Official - Phone:888-976-0969
Mailing Address - Street 1:952 WILLIAM DR
Mailing Address - Street 2:
Mailing Address - City:SAN LORENZO
Mailing Address - State:CA
Mailing Address - Zip Code:94580-1555
Mailing Address - Country:US
Mailing Address - Phone:888-976-0969
Mailing Address - Fax:
Practice Address - Street 1:2603 CAMINO RAMON STE 200
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-9137
Practice Address - Country:US
Practice Address - Phone:888-976-0969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care