Provider Demographics
NPI:1649200833
Name:ANGELS HOME HEALTH AGENCY
Entity type:Organization
Organization Name:ANGELS HOME HEALTH AGENCY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ASONIBE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:469-264-4227
Mailing Address - Street 1:1325 BOYD ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-5086
Mailing Address - Country:US
Mailing Address - Phone:469-264-4227
Mailing Address - Fax:877-850-5030
Practice Address - Street 1:1325 BOYD ST
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-5086
Practice Address - Country:US
Practice Address - Phone:469-454-6826
Practice Address - Fax:877-850-5030
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANGELS HOME HEALTH AGENCY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-03
Last Update Date:2025-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WC1600X, 163WD0400X, 163WL0100X, 163WM0102X, 163WP0808X, 163WR1000X, 174H00000X, 207V00000X, 251B00000X, 251F00000X, 251J00000X, 3104A0625X, 324500000X, 385HR2060X
TX008103251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff DevelopmentGroup - Multi-Specialty
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Multi-Specialty
No163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty
No163WM0102XNursing Service ProvidersRegistered NurseMaternal NewbornGroup - Multi-Specialty
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty
No163WR1000XNursing Service ProvidersRegistered NurseReproductive Endocrinology/InfertilityGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679045Medicare Oscar/Certification