Provider Demographics
NPI:1457754475
Name:ANGEL PERSONAL TOUCH
Entity Type:Organization
Organization Name:ANGEL PERSONAL TOUCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/
Authorized Official - Prefix:MS
Authorized Official - First Name:LORNA
Authorized Official - Middle Name:ANGELA
Authorized Official - Last Name:MOLLISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-777-5119
Mailing Address - Street 1:1203 HARVEST DALE CT
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30088-2754
Mailing Address - Country:US
Mailing Address - Phone:678-777-5119
Mailing Address - Fax:770-413-3821
Practice Address - Street 1:1203 HARVEST DALE CT
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30088-2754
Practice Address - Country:US
Practice Address - Phone:678-777-5119
Practice Address - Fax:770-413-3821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-04
Last Update Date:2014-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044-R-1258251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health