Provider Demographics
NPI:1639405095
Name:ANGELSTAR HOME HEALTH CARE
Entity Type:Organization
Organization Name:ANGELSTAR HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-597-3425
Mailing Address - Street 1:4307 S BOWEN RD # 159
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-4902
Mailing Address - Country:US
Mailing Address - Phone:682-597-3425
Mailing Address - Fax:817-855-5188
Practice Address - Street 1:4307 S BOWEN RD # 159
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-4902
Practice Address - Country:US
Practice Address - Phone:682-597-3425
Practice Address - Fax:817-855-5188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health