Provider Demographics
NPI:1245832559
Name:ANGELIC PATHS LLC
Entity type:Organization
Organization Name:ANGELIC PATHS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:KUCHTA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:484-225-4668
Mailing Address - Street 1:188 MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:EMMAUS
Mailing Address - State:PA
Mailing Address - Zip Code:18049-4015
Mailing Address - Country:US
Mailing Address - Phone:888-264-3501
Mailing Address - Fax:610-945-0428
Practice Address - Street 1:188 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:EMMAUS
Practice Address - State:PA
Practice Address - Zip Code:18049-4015
Practice Address - Country:US
Practice Address - Phone:888-264-3501
Practice Address - Fax:610-945-0428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-11
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based