Provider Demographics
NPI:1679049670
Name:MISTY'S ANGELS HOME HEALTH CARE LLC.
Entity Type:Organization
Organization Name:MISTY'S ANGELS HOME HEALTH CARE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIARA
Authorized Official - Middle Name:T
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:141-290-1820
Mailing Address - Street 1:104 WYNOKA ST APT 1
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15210-3646
Mailing Address - Country:US
Mailing Address - Phone:412-290-1820
Mailing Address - Fax:
Practice Address - Street 1:104 WYNOKA ST APT 1
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15210-3646
Practice Address - Country:US
Practice Address - Phone:412-290-1820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health