Provider Demographics
NPI:1659148476
Name:G.L.A.S. ANGELS CARE HOME
Entity Type:Organization
Organization Name:G.L.A.S. ANGELS CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LASHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-313-3544
Mailing Address - Street 1:496 HIGHPOINT XING
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-5112
Mailing Address - Country:US
Mailing Address - Phone:770-313-3544
Mailing Address - Fax:
Practice Address - Street 1:496 HIGHPOINT XING
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-5112
Practice Address - Country:US
Practice Address - Phone:770-313-3544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-12
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care