Provider Demographics
NPI:1952825556
Name:EYES OF ANGELS IN HOME CARE AND GOLDEN RETREAT ASSISTED LIVING, LLC
Entity Type:Organization
Organization Name:EYES OF ANGELS IN HOME CARE AND GOLDEN RETREAT ASSISTED LIVING, LLC
Other - Org Name:EYES OF ANGELS IN HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:CHICO
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-535-0576
Mailing Address - Street 1:5710 COBALT LN
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-5295
Mailing Address - Country:US
Mailing Address - Phone:254-206-3864
Mailing Address - Fax:
Practice Address - Street 1:600 INDIAN TRL STE 205
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-1370
Practice Address - Country:US
Practice Address - Phone:254-206-3864
Practice Address - Fax:254-206-3863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-26
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health