Provider Demographics
NPI:1831703636
Name:UNIQUEANGLESHOMECARESERVICES
Entity type:Organization
Organization Name:UNIQUEANGLESHOMECARESERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VESHAY
Authorized Official - Middle Name:ELISE
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-838-3306
Mailing Address - Street 1:257 MANER TER SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-1930
Mailing Address - Country:US
Mailing Address - Phone:404-507-2360
Mailing Address - Fax:
Practice Address - Street 1:257 MANER TER SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-1930
Practice Address - Country:US
Practice Address - Phone:404-838-3306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2020-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care