Provider Demographics
NPI:1710617501
Name:LOYAL ANGELS HOME CARE
Entity Type:Organization
Organization Name:LOYAL ANGELS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:LATOYA
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-586-9243
Mailing Address - Street 1:919 TRUE ST STE B3
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29209-1662
Mailing Address - Country:US
Mailing Address - Phone:803-401-5735
Mailing Address - Fax:
Practice Address - Street 1:919 TRUE ST STE B3
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-1662
Practice Address - Country:US
Practice Address - Phone:803-401-5735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care