Provider Demographics
NPI:1245436443
Name:LIFE OF ANGELS HOME HEALTH CARE INC
Entity type:Organization
Organization Name:LIFE OF ANGELS HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELSA
Authorized Official - Middle Name:N
Authorized Official - Last Name:BURKHOLDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-423-5900
Mailing Address - Street 1:1617 PALM VALLEY DR E
Mailing Address - Street 2:1617 PALM VALLEY DR.EAST
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-9007
Mailing Address - Country:US
Mailing Address - Phone:956-423-5900
Mailing Address - Fax:956-423-5900
Practice Address - Street 1:1617 PALM VALLEY DR E
Practice Address - Street 2:1617 PALM VALLEY DR. EAST
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-9007
Practice Address - Country:US
Practice Address - Phone:956-423-5900
Practice Address - Fax:956-423-5900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010995251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health