Provider Demographics
NPI:1730481276
Name:ANGELS OF LOVE CAREGIVER SERVICE
Entity Type:Organization
Organization Name:ANGELS OF LOVE CAREGIVER SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:TYRANN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:12/09/1957
Authorized Official - Phone:336-558-1587
Mailing Address - Street 1:2824 VANSTORY ST APT 1C
Mailing Address - Street 2:2824-1C-VANSTROY ST
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-4782
Mailing Address - Country:US
Mailing Address - Phone:336-558-1587
Mailing Address - Fax:
Practice Address - Street 1:2824 VANSTORY ST APT 1C
Practice Address - Street 2:2824-1C-VANSTROY ST
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-4782
Practice Address - Country:US
Practice Address - Phone:336-558-1587
Practice Address - Fax:336-617-3969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health