Provider Demographics
NPI:1942810809
Name:PURPOSEFUL ANGELS HOME CARE LLC
Entity Type:Organization
Organization Name:PURPOSEFUL ANGELS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADESUWA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLABANJI
Authorized Official - Suffix:
Authorized Official - Credentials:CSCM
Authorized Official - Phone:510-910-4033
Mailing Address - Street 1:333 DANBURY PL
Mailing Address - Street 2:
Mailing Address - City:LATHROP
Mailing Address - State:CA
Mailing Address - Zip Code:95330-8877
Mailing Address - Country:US
Mailing Address - Phone:510-910-4033
Mailing Address - Fax:
Practice Address - Street 1:6701 KOLL CENTER PKWY STE 250
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-8062
Practice Address - Country:US
Practice Address - Phone:209-362-0425
Practice Address - Fax:209-297-4319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-05
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child