Provider Demographics
NPI:1922199025
Name:ANGELIC TOUCH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:ANGELIC TOUCH CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:D
Authorized Official - Last Name:CHAMPAGNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-394-3840
Mailing Address - Street 1:PO BOX 615
Mailing Address - Street 2:
Mailing Address - City:SAINT MARTINVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70582-0615
Mailing Address - Country:US
Mailing Address - Phone:337-394-3840
Mailing Address - Fax:337-394-7762
Practice Address - Street 1:112 EVANGELINE BLVD
Practice Address - Street 2:
Practice Address - City:SAINT MARTINVILLE
Practice Address - State:LA
Practice Address - Zip Code:70582-4541
Practice Address - Country:US
Practice Address - Phone:337-394-3840
Practice Address - Fax:337-394-7762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1180921Medicare UPIN