Provider Demographics
NPI:1821864398
Name:TOUCHED BY AN ANGEL HOME CARE LLC
Entity Type:Organization
Organization Name:TOUCHED BY AN ANGEL HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAVORIS
Authorized Official - Middle Name:MONTE
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-740-6266
Mailing Address - Street 1:202 FERNWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28360-8802
Mailing Address - Country:US
Mailing Address - Phone:910-774-6550
Mailing Address - Fax:
Practice Address - Street 1:108 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:ROWLAND
Practice Address - State:NC
Practice Address - Zip Code:28383
Practice Address - Country:US
Practice Address - Phone:910-740-6266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care