Provider Demographics
NPI:1477389013
Name:ANGEL A CARE HOME
Entity type:Organization
Organization Name:ANGEL A CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRISCOE-HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-548-0466
Mailing Address - Street 1:6066 E 129TH ST
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:MO
Mailing Address - Zip Code:64030-2631
Mailing Address - Country:US
Mailing Address - Phone:816-548-0466
Mailing Address - Fax:
Practice Address - Street 1:6066 E 129TH ST
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:MO
Practice Address - Zip Code:64030-2631
Practice Address - Country:US
Practice Address - Phone:816-548-0466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health