Provider Demographics
NPI:1629816533
Name:PAIDEN ANGELS HOME HEALTH SERVICES LLC
Entity type:Organization
Organization Name:PAIDEN ANGELS HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:314-537-5902
Mailing Address - Street 1:100 S 4TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63102-1821
Mailing Address - Country:US
Mailing Address - Phone:314-458-4153
Mailing Address - Fax:
Practice Address - Street 1:100 S 4TH ST STE 100
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63102-1821
Practice Address - Country:US
Practice Address - Phone:314-458-4153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health