Provider Demographics
NPI:1255580296
Name:AVALON ANGELS NURSING & CAREGIVER SERVICES, INC.
Entity type:Organization
Organization Name:AVALON ANGELS NURSING & CAREGIVER SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:MS
Authorized Official - First Name:FRITZIE
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:MACIAS-THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-435-7755
Mailing Address - Street 1:1557 E AMAR RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-1678
Mailing Address - Country:US
Mailing Address - Phone:162-643-5775
Mailing Address - Fax:
Practice Address - Street 1:1557 E AMAR RD
Practice Address - Street 2:SUITE H
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91792-1678
Practice Address - Country:US
Practice Address - Phone:162-643-5775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health