Provider Demographics
NPI:1811016991
Name:ANGEL CARE HOME HEALTH SERVICES,INC.
Entity Type:Organization
Organization Name:ANGEL CARE HOME HEALTH SERVICES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MALIYIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-262-6435
Mailing Address - Street 1:1839 S CARRIER PKWY
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-3702
Mailing Address - Country:US
Mailing Address - Phone:972-262-6435
Mailing Address - Fax:972-237-1495
Practice Address - Street 1:1839 S CARRIER PKWY
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-3702
Practice Address - Country:US
Practice Address - Phone:972-262-6435
Practice Address - Fax:972-237-1495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX005225251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX459412Medicare ID - Type Unspecified