Provider Demographics
NPI:1821010794
Name:ANGEL HEARTS PLUS, LLC
Entity Type:Organization
Organization Name:ANGEL HEARTS PLUS, LLC
Other - Org Name:ANGEL HEARTS HOME HEALTH CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:DON
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:937-263-6194
Mailing Address - Street 1:2 RIVER PL STE 310
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-4936
Mailing Address - Country:US
Mailing Address - Phone:937-263-6194
Mailing Address - Fax:937-263-6194
Practice Address - Street 1:2 RIVER PL STE 310
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-4936
Practice Address - Country:US
Practice Address - Phone:937-263-6194
Practice Address - Fax:937-263-6648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2638195Medicaid
OH2638195Medicaid