Provider Demographics
NPI:1811582075
Name:ANGEL HOME HEALTH LLC
Entity Type:Organization
Organization Name:ANGEL HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DING
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-890-8953
Mailing Address - Street 1:4086 TULARE DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-1704
Mailing Address - Country:US
Mailing Address - Phone:925-890-8953
Mailing Address - Fax:
Practice Address - Street 1:3498 CLAYTON RD STE 101
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94519-2461
Practice Address - Country:US
Practice Address - Phone:925-689-2395
Practice Address - Fax:925-887-6558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-09
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health