Provider Demographics
NPI:1750688958
Name:EARTH ANGELS HEALTHCARE LLC
Entity Type:Organization
Organization Name:EARTH ANGELS HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:SHELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOLLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-414-7445
Mailing Address - Street 1:2100 SOUTHBRIDGE PKWY
Mailing Address - Street 2:STE 650
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-1401
Mailing Address - Country:US
Mailing Address - Phone:205-414-7445
Mailing Address - Fax:205-414-7400
Practice Address - Street 1:2100 SOUTHBRIDGE PKWY
Practice Address - Street 2:STE 650
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-1401
Practice Address - Country:US
Practice Address - Phone:205-414-7445
Practice Address - Fax:205-414-7400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health