Provider Demographics
NPI:1760759112
Name:ANGELS HEART HOME CARE, LLC
Entity Type:Organization
Organization Name:ANGELS HEART HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRISBY
Authorized Official - Suffix:
Authorized Official - Credentials:BS, SOCIOLOGY
Authorized Official - Phone:225-364-2033
Mailing Address - Street 1:2035 WOODDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-1517
Mailing Address - Country:US
Mailing Address - Phone:225-364-2033
Mailing Address - Fax:225-364-2190
Practice Address - Street 1:2035 WOODDALE BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-1517
Practice Address - Country:US
Practice Address - Phone:225-364-2033
Practice Address - Fax:225-364-2190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2203781016251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based