Provider Demographics
NPI:1760707632
Name:HEAVEN'S ANGELS HOME CARE
Entity Type:Organization
Organization Name:HEAVEN'S ANGELS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNA
Authorized Official - Middle Name:N
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-619-0233
Mailing Address - Street 1:127 GRACE AVE
Mailing Address - Street 2:
Mailing Address - City:BARNESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43713-1407
Mailing Address - Country:US
Mailing Address - Phone:740-619-0233
Mailing Address - Fax:740-619-0233
Practice Address - Street 1:127 GRACE AVE
Practice Address - Street 2:
Practice Address - City:BARNESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43713-1407
Practice Address - Country:US
Practice Address - Phone:740-619-0233
Practice Address - Fax:740-619-0233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-02
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1920534251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health