Provider Demographics
NPI:1710046933
Name:A STAR FOR AN ANGEL HOME CARE INC
Entity Type:Organization
Organization Name:A STAR FOR AN ANGEL HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AGENCY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:BROWN
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-865-8431
Mailing Address - Street 1:229 S WILLOW STREET
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-2792
Mailing Address - Country:US
Mailing Address - Phone:704-865-8431
Mailing Address - Fax:704-865-8689
Practice Address - Street 1:229 S WILLOW STREET
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2792
Practice Address - Country:US
Practice Address - Phone:704-865-8431
Practice Address - Fax:704-865-8689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
NCHC3150251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251E00000XAgenciesHome Health
Not Answered251J00000XAgenciesNursing Care