Provider Demographics
NPI:1811289119
Name:ANGEL HANDS COMPANION SERVICES
Entity type:Organization
Organization Name:ANGEL HANDS COMPANION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:PATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:GODSHAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-444-4112
Mailing Address - Street 1:1357 KINGSLEY AVE
Mailing Address - Street 2:6
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4588
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1357 KINGSLEY AVE
Practice Address - Street 2:6
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4588
Practice Address - Country:US
Practice Address - Phone:904-444-4112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-05
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL231395251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health