Provider Demographics
NPI:1184976060
Name:BEVERLY'S ANGELS
Entity type:Organization
Organization Name:BEVERLY'S ANGELS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:HUNTER
Authorized Official - Last Name:PEARCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-987-0077
Mailing Address - Street 1:201 W 8TH ST STE 206
Mailing Address - Street 2:PO BOX 5011
Mailing Address - City:PARIS
Mailing Address - State:KY
Mailing Address - Zip Code:40361-1372
Mailing Address - Country:US
Mailing Address - Phone:859-987-0077
Mailing Address - Fax:859-987-2279
Practice Address - Street 1:201 W 8TH ST
Practice Address - Street 2:SUITE 206
Practice Address - City:PARIS
Practice Address - State:KY
Practice Address - Zip Code:40361-1371
Practice Address - Country:US
Practice Address - Phone:859-987-0077
Practice Address - Fax:859-987-2279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY500040253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care