Provider Demographics
NPI:1720714025
Name:ANGELS OF LOVE ADULT CARE INC
Entity Type:Organization
Organization Name:ANGELS OF LOVE ADULT CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-942-3994
Mailing Address - Street 1:1215 OGLETHORPE AVE
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31709-3267
Mailing Address - Country:US
Mailing Address - Phone:229-942-3994
Mailing Address - Fax:
Practice Address - Street 1:1215 OGLETHORPE AVE
Practice Address - Street 2:
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31709-3267
Practice Address - Country:US
Practice Address - Phone:229-942-3994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care