Provider Demographics
NPI:1740805001
Name:MY ANGEL HOME CARE LLC
Entity Type:Organization
Organization Name:MY ANGEL HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMNISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WANORUE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:346-264-2660
Mailing Address - Street 1:24906 GRAND SAPPHIRE LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-3224
Mailing Address - Country:US
Mailing Address - Phone:346-264-2660
Mailing Address - Fax:
Practice Address - Street 1:24906 GRAND SAPPHIRE LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-3224
Practice Address - Country:US
Practice Address - Phone:346-264-2660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-12
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care