Provider Demographics
NPI:1891906699
Name:GERIATRIC ANGELS, INC.
Entity Type:Organization
Organization Name:GERIATRIC ANGELS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:F
Authorized Official - Last Name:DAVENPORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-670-0234
Mailing Address - Street 1:9600 HIGHWAY 46
Mailing Address - Street 2:
Mailing Address - City:BON AQUA
Mailing Address - State:TN
Mailing Address - Zip Code:37025-2774
Mailing Address - Country:US
Mailing Address - Phone:931-670-0234
Mailing Address - Fax:931-670-0035
Practice Address - Street 1:9600 HIGHWAY 46
Practice Address - Street 2:
Practice Address - City:BON AQUA
Practice Address - State:TN
Practice Address - Zip Code:37025-2774
Practice Address - Country:US
Practice Address - Phone:931-670-0234
Practice Address - Fax:931-670-0035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3644251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health