Provider Demographics
NPI:1811045024
Name:ANGEL LIVING INCORPORATED
Entity Type:Organization
Organization Name:ANGEL LIVING INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MBOCK
Authorized Official - Last Name:AKO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:281-498-0020
Mailing Address - Street 1:11934 HUECO TANKS DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-7356
Mailing Address - Country:US
Mailing Address - Phone:281-498-0020
Mailing Address - Fax:281-498-2898
Practice Address - Street 1:11934 HUECO TANKS DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-7356
Practice Address - Country:US
Practice Address - Phone:281-498-0020
Practice Address - Fax:281-498-2898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty