Provider Demographics
NPI:1629565122
Name:ALLY ANGEL CARE LLC
Entity Type:Organization
Organization Name:ALLY ANGEL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:EL ABBASSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-226-3716
Mailing Address - Street 1:5128 PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-2611
Mailing Address - Country:US
Mailing Address - Phone:513-628-8866
Mailing Address - Fax:
Practice Address - Street 1:5128 PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-2611
Practice Address - Country:US
Practice Address - Phone:513-628-8866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health