Provider Demographics
NPI:1255732749
Name:ANGELS AT YOUR SERVICE
Entity type:Organization
Organization Name:ANGELS AT YOUR SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:WAITHIRA
Authorized Official - Last Name:GITAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-446-5670
Mailing Address - Street 1:8027 CARTEN ST
Mailing Address - Street 2:8027 CARTEN ST
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-3750
Mailing Address - Country:US
Mailing Address - Phone:404-446-5670
Mailing Address - Fax:
Practice Address - Street 1:8027 CARTEN ST
Practice Address - Street 2:8027 CARTEN ST
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-3750
Practice Address - Country:US
Practice Address - Phone:404-446-5670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health