Provider Demographics
NPI:1801472782
Name:ANGEL CARE COMPANION SERVICES, INC.
Entity type:Organization
Organization Name:ANGEL CARE COMPANION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTH
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:631-310-6091
Mailing Address - Street 1:34 E MAIN ST STE 430
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2804
Mailing Address - Country:US
Mailing Address - Phone:631-310-6091
Mailing Address - Fax:
Practice Address - Street 1:217 HAWTHORNE AVE APT 7
Practice Address - Street 2:
Practice Address - City:CENTRAL ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11722-1306
Practice Address - Country:US
Practice Address - Phone:631-310-6091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health