Provider Demographics
NPI:1669825915
Name:ANGELS ON CALL HOME CARE AGENCY
Entity Type:Organization
Organization Name:ANGELS ON CALL HOME CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WINDOLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SUBER
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:470-800-1220
Mailing Address - Street 1:2 HAVEN RIDGE PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-2882
Mailing Address - Country:US
Mailing Address - Phone:470-800-1220
Mailing Address - Fax:800-884-0484
Practice Address - Street 1:2 HAVEN RIDGE PL
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-2882
Practice Address - Country:US
Practice Address - Phone:470-800-1220
Practice Address - Fax:800-884-0484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-21
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care