Provider Demographics
NPI:1912543018
Name:ANGELFAITH PEDIATRIC HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:ANGELFAITH PEDIATRIC HOME HEALTH CARE, LLC
Other - Org Name:ANGELFAITH HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DONSHANEICE
Authorized Official - Middle Name:MECHELLE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-800-5729
Mailing Address - Street 1:17703 CYPRESS HILL DR
Mailing Address - Street 2:
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583-8266
Mailing Address - Country:US
Mailing Address - Phone:281-369-0690
Mailing Address - Fax:833-877-1558
Practice Address - Street 1:17703 CYPRESS HILL DR
Practice Address - Street 2:
Practice Address - City:ROSHARON
Practice Address - State:TX
Practice Address - Zip Code:77583-8266
Practice Address - Country:US
Practice Address - Phone:281-369-0690
Practice Address - Fax:833-877-1558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-23
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing CareGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child