Provider Demographics
NPI:1821607078
Name:INSPIRED ANGELS HOME CARE LLC
Entity Type:Organization
Organization Name:INSPIRED ANGELS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:GENEVOLYN
Authorized Official - Middle Name:T
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-340-7357
Mailing Address - Street 1:307 STEADMAN LN
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-1059
Mailing Address - Country:US
Mailing Address - Phone:901-340-3357
Mailing Address - Fax:
Practice Address - Street 1:1661 INTERNATIONAL PLACE DR STE 400
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-1431
Practice Address - Country:US
Practice Address - Phone:901-340-7357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty