Provider Demographics
NPI:1720376650
Name:ANGEL CARE PLUS HOSPICE, LLC
Entity Type:Organization
Organization Name:ANGEL CARE PLUS HOSPICE, LLC
Other - Org Name:ANGEL CARE HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MATHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:KORAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-301-5600
Mailing Address - Street 1:1350 E ARAPAHO RD STE 207
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-2453
Mailing Address - Country:US
Mailing Address - Phone:972-301-5600
Mailing Address - Fax:972-301-5606
Practice Address - Street 1:1350 E ARAPAHO RD STE 207
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-2453
Practice Address - Country:US
Practice Address - Phone:972-301-5600
Practice Address - Fax:972-301-5606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX671675Medicare PIN