Provider Demographics
NPI:1689131922
Name:ANGELINE HOME CARE SERVICES, INC.
Entity Type:Organization
Organization Name:ANGELINE HOME CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRINIDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-283-3790
Mailing Address - Street 1:1305 W BULLARD AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-2469
Mailing Address - Country:US
Mailing Address - Phone:559-779-4663
Mailing Address - Fax:559-492-1787
Practice Address - Street 1:1305 W BULLARD AVE STE 3
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-2469
Practice Address - Country:US
Practice Address - Phone:559-779-4663
Practice Address - Fax:559-492-1787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care